By Nimfa Estrellado During the 'Kapihan sa Bagong Pilipinas' held at the St. Jude Hotel and Event Center in Tayabas City, Quezon on ...
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| During the 'Kapihan sa Bagong Pilipinas' held at the St. Jude Hotel and Event Center in Tayabas City, Quezon on Tuesday, September 10, 2024, Dr. Edwin Oriña, acting regional vice president of PhilHealth for Calabarzon, talks about the new initiatives of the organization in the region. (Photo from PIA CALABARZON) |
LUCENA CITY, Quezon - Residents of Quezon province are set to experience a transformative shift in primary healthcare with the launch of "Konsultasyong Sulit at Tama" or "Konsulta," a groundbreaking pilot program by PhilHealth-Calabarzon (PhilHealth-4A). This initiative, unveiled at the "Kapihan sa Bagong Pilipinas" forum in Tayabas City, will empower nearly half a million individuals with unprecedented access to a wide array of essential outpatient services, all enshrined in the Universal Health Care Law.
In a bold move to strengthen the foundation of healthcare in the region, PhilHealth-4A is spearheading this pilot program across 49 rural health units (RHUs) in Quezon province. Konsulta is poised to redefine primary care delivery, offering comprehensive outpatient benefits ranging from consultations with healthcare professionals and preventive health risk screenings to diagnostic laboratory tests and medication provision, ensuring that individuals receive the timely and appropriate care they need, right at their doorstep.
The program's innovative capitation-based model, a departure from traditional fee-for-service systems, provides upfront funding to healthcare facilities, empowering them to take a proactive and holistic approach to patient care. This strategic shift towards preventive and proactive care aligns seamlessly with the core principles of Universal Health Care, fostering a healthier and more resilient population.
PhilHealth's vision extends far beyond primary care, with ambitious plans to establish a comprehensive Health Care Provider Network (HCPN) that seamlessly integrates primary, secondary, and tertiary care providers. This interconnected network will ensure a smooth and coordinated continuum of care, guiding patients through every stage of their healthcare journey, from prevention and early detection to treatment and rehabilitation.
A cornerstone of the HCPN is the groundbreaking PhilHealth GAMOT program, which will grant beneficiaries access to a basket of 53 essential drugs, valued at PHP9,000 annually. This initiative will significantly alleviate the financial burden of medication costs, making healthcare more affordable and equitable for all, regardless of socioeconomic status. Quezon's HCPN is slated to launch later this year, with Laguna following suit in 2025.
Quezon province's unwavering dedication to providing accessible and quality healthcare services is evident in its recent receipt of over 100 million pesos in capitation funding for the Konsulta program. Governor Helen Tan personally accepted the funds, urging residents to seize this opportunity to take control of their health by registering at their nearest RHU or primary network hospital.
A productive meeting of the PCPN Steering Committee, led by PhilHealth Regional Office IVA, underscored the critical role of collaboration in ensuring that enrolled members receive appropriate and timely care. A visit to the Tayabas City Health Office provided firsthand insights into the PhilHealth Konsulta process, highlighting the importance of coordinated efforts among healthcare providers in achieving optimal health outcomes. The meeting also emphasized the committee's priority duties, including ensuring proper patient encounters and consultations, and increasing PhilHealth Konsulta membership registration.
The CALABARZON region stands out as a beacon of success in the implementation of the Universal Health Care Law, boasting a wide and actively engaged PhilHealth membership. This achievement is a testament to the region's unwavering commitment to ensuring that all residents have access to quality healthcare services, regardless of their socioeconomic background. Out of the 17 regions covered by PhilHealth benefits, CALABARZON was recognized for its wide and active membership.
PhilHealth continues to push the boundaries of innovation, exploring the use of Artificial Intelligence to streamline customer services and expedite processing times, ensuring a seamless and hassle-free experience for members. The agency is also committed to expanding its benefit packages to encompass a wider range of diseases, leaving no one behind in the pursuit of health and well-being. In partnership with PIA - Quezon, Dr. Edwin M. Oriña, Acting Regional Vice President, highlighted the agency's achievements and comprehensive programs, including increased and expanded services for preventive care, mental care, and catastrophic illnesses.
There has been an increase in all Case Rates Packages, covering 7,000 diseases, with a 30% additional benefit recorded since February 14th. Rationalized cases for disease groups needing increased benefits based on cost-benefit analysis were also clarified. The Hemodialysis Benefit Package received particular attention due to the high number of cases, with benefits increasing from 2,600.00 to 4,000.00 with 156 sessions per year, representing a 54% increase in services.
PhilHealth Plus was introduced as a new benefit for members with insufficient contributions, offering additional coverage for excess fees in health benefits starting next year. The agency is also looking into digitization and the use of Artificial Intelligence in customer services to reduce processing times for member inquiries and complaints.
Quezon province's leadership in embracing PhilHealth's primary care initiatives, coupled with the agency's relentless pursuit of innovation and service enhancement, heralds a new era of accessible, affordable, and quality healthcare for all Filipinos. This is a testament to the power of collaboration, innovation, and a shared vision for a healthier and more prosperous nation.
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