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PhilHealth forms PH’s first 7 primary care networks

The Philippine Health Insurance Corporation (PhilHealth) on Monday partnered with five local government units (LGUs) and two private sector groups to establish the first seven primary care networks in the country.

The Department of Health (DOH) said a Primary Care Provider Network (PCPN) would implement a strategy on a “sandbox” or testing basis in pre-selected areas, by allowing advanced payments or frontloading of funds even before services have been rendered.

The current PhilHealth Konsultasyong Sulit at Tama (Konsulta) primary care benefit package covers patient consultations, any of 13 laboratory and diagnostic tests as ordered by the doctor, and 21 common medications that can be prescribed according to their medical needs.

PhilHealth then pays its Konsulta providers an amount ranging from P500-750 per patient per year, on a reimbursement basis after services have been rendered.

With the first few local primary care networks formed under the Universal Health Care (UHC) Act, DOH said around two million Filipinos in Bataan, Guimaras, Quezon, South Cotabato, and Baguio City are expected to benefit.

Meanwhile, 300,000 more Filipinos who are under the care of the LiFE group as well as QualiMed could also benefit from the improvements in primary care financing.

The seven Konsulta PCPNs caring for a total of 2.3 million individuals are projected to be paid a total of P1.2 billion, which may be used to improve infrastructure, equipment, and staff compensation even before the first patient starts using services.

Health Secretary and PhilHealth Chairperson of the Board Ted Herbosa, stressed the importance of UHC, saying the DOH and its stakeholders look forward to the developments from the implementation of these primary care networks.

“Primary care and essential public health services, integrated with a broader health care network of hospitals and other facilities, is a key element needed for universal health care to happen. Dapat ramdam ng bawat Pilipino ang UHC (every Filipino should feel the UHC),” he said. — DVM, GMA Integrated News