CALAMBA CITY, Laguna – The Philippine Health Insurance Corporation-Calabarzon (PhilHealth-4A) has launched a pilot program for its Primary Care Provider Network (PCPN) in 49 rural health units (RHUs) in Quezon province.
At the “Kapihan sa Bagong Pilipinas” forum held Tuesday at St. Jude Hotel and Event Center in Tayabas City, Dr. Edwin Oriña, acting regional vice president of PhilHealth, announced the initiative dubbed “Konsultasyong Sulit at Tama,” or “Konsulta,” which aims to set a model for primary care provision through the PCPN.
The PCPN is targeting 490,000 individuals across the 49 RHUs in the province.
The Konsulta program provides comprehensive outpatient benefits as mandated by the Universal Health Care Law, including consultations, health risk screenings, assessments, selected laboratory and diagnostic tests, and specific drugs and medicines.
Under the Konsulta regular scheme, a set amount of money is allocated after the patient first encounter (capitation) to cover anticipated healthcare costs for each patient.
In the PCPN model, this capitation is frontloaded, allowing facilities to address patient needs, whether they are sick or well, without waiting for the funding to be processed.
Oriña also discussed future plans for creating a Health Care Provider Network (HCPN), which will include a range of primary to tertiary care providers, both public and private.
The HCPN will introduce the PhilHealth GAMOT program, which stands for Guaranteed Accessible Medication for Outpatient Treatment. This initiative will provide patients with access to 53 types of drugs valued at PHP9,000 annually.
Oriña said the HCPN will be established in Quezon later this year, with a similar rollout planned for Laguna in 2025.
The PhilHealth Konsulta program aims to safeguard Filipinos’ health by preventing chronic illnesses, detecting complications early, and offering affordable medications. (PNA)