PhilHealth partners with Primary Care Provider Networks for Konsulta implementation

The Philippine Health Insurance Corporation (PhilHealth) has just signed Service Level Agreements (SLAs) with the first seven Primary Care Provider Networks (PCPNs) ever to be formed in the country for a more effective delivery of primary care services through its Konsultasyong Sulit at Tama or Konsulta Package.

Under the agreement, the five (5) public PCPNs consisting of the Provinces of Bataan, Guimaras, Quezon, South Cotabato and the City of Baguio; and two private PCPNs namely Qualimed and LABX shall serve as sandbox sites (or test sites) for the increased registration using projective payment mechanism.

Filipinos under the PhilHealth Konsulta Package which will now be financed via or frontloaded capitation. Some 2.3 million Filipinos within these networks stand to benefit from a projected P1.2 billion in funding from the state health insurer.

In his message via online, PhilHealth Acting President and CEO Emmanuel R. Ledesma, Jr. states that “we are one step closer to achieving a comprehensive approach to deliver primary care for our Kababayans. I cannot thank you enough for making this happen. Let us make PCPN work as envisioned and serve its purpose for our people,” he added.

The PhilHealth PCPN Konsulta provides consultations, health risk screening and assessment, and 13 laboratory tests and 21 essential medicines. This package will eventually expands into a comprehensive outpatient benefit package as envisioned in the Universal Health Care Law and in response to the President Ferdinand R. Marcos, Jr.’s thrust of reducing out-of-pocket expenditures in health in line with the government’s vision “Matatag, Maginhawa at Panatag na Buhay” for all Filipinos by 2040.

Among those present during the ceremonial signing ceremony recently held at the PhilHealth Head Office in Pasig City were (seated from left) Gov. Angelina Helen D.L. Tan of Quezon, former Health Secretary and Strategic Advisory Group of Experts (SAGE) on UHC member Dr. Esperanza Cabral, Rep. Stella Luz A. Quimbo of Marikina City’s 2^nd District, Health Secretary Dr. Teodoro J. Herbosa, PhilHealth Board Member Dr. Jack Arroyo, and Dr. Alejandro Herrin of USAID-Protect Health.  Standing from left were SVP for Fund Management Renato L. Limsiaco, Jr., OIC-Corporate Secretary Atty. Lora Mangasar, Region VI VP Janet Monteverde, Guimaras Vice Governor John Edward Gando, CAR VP Dominga Gadgad, Baguio City Mayor Benjamin Magalong, Region IV-A VP Dr. Danilo Reynes (PRO IV-A),    Dr. Mike Vergara of LABX, South Cotabato Gov. Reynaldo Tamayo, Jr., Jimmy Ismail of Qualimed; Bataan Gov. Jose Enrique Garcia III, Region XII VP Dr. Hector Zenon Malate, NCR VP Dr. Bernadette Lico, and Region III VP Edgardo Faustino.