AS PART of its plan to provide a primary care benefit package for its direct and indirect members in Central Visayas, the Philippine Health Insurance Corporation (PhilHealth) 7 is eyeing Malabuyoc, Cebu as one of its areas for pilot testing.
The town has passed the criteria to implement the PhilHealth Konsultasyong Sulit at Tama (Konsulta) Package, which includes the willingness to participate, compliance with the standards to be an accredited Konsulta provider, and the presence of an integrated local health system.
The Konsulta Package is what PhilHealth considers as an initial step toward adopting a comprehensive approach to delivering primary care to all Filipinos.
It is paid per capita and covers a defined set of primary care health services based on their life stage, health risks, and needs to which all Filipinos are entitled, according to PhilHealth Circular 2020-0021.
Primary care
Dina Cinchez, public relations officer of PhilHealth 7, said that the Konsulta Package aims to encourage Filipinos to avail of primary care to prevent serious health problems.
She said that the Konsulta Package includes basic diagnostic screening like complete blood count and other outpatient treatment, which members can avail of in PhilHealth-accredited Konsulta providers.
Service capabilities of Konsulta providers must include the ability to conduct preventive or screening services and health education, such as consultation, blood pressure and vital signs measurements, clinical breast examination, digital rectal examination, and risk profiling for hypertension and diabetes.
They must also be capable of providing services for required laboratory and radiologic services and dispense required medicines.
While all regions in the country have been asked to provide potential areas for pilot testing of the Konsulta Package, other areas initially identified for pilot testing include Bataan, Biliran, Eastern Samar, Leyte, Northern Samar, Samar, Sorsogon, Southern Leyte, South Cotabato, Ormoc, and Tacloban.
Pilot testing
Pilot testing will be done within the first half of 2021.
During the pilot testing period, all health facilities will conduct a self-assessment to determine its capability to comply with the standards of the package and fill up a provider data record. To become Konsulta providers, they must submit accreditation documents to the regional or local health office.
For non-licensed health facilities, PhilHealth will conduct a pre-accreditation survey to validate compliance. Approved applicants will receive a Certificate of Accreditation.
Implementation of the Konsulta Package in the non-pilot sites will start in the second half of the year.
Cinchez said that PhilHealth expanded the Primary Care Benefit Package in 2019 to include the formal economy or employed sector, lifetime, and senior citizen members. Before the pandemic was announced in the country in 2020, PhilHealth issued the governing policies of the Konsulta Package to cover all Filipinos. (Mary Francis Lynn Caayon, St. Theresa’s College Media Communication student)