"Paying whichever is lower does not change the payment mechanism from ACR to FFS." This is true. Choosing to pay whichever is lower will not automatically change the payment mechanism from All Case Rates (Case-based payment) to Fee-for-Service. The "change" in payment mechanism does not depend on how we choose to pay, but on what … Continue reading Bill vs. ACR: Should the government pay for whichever is lower?
Health Policy
Government should provide financial support to PhilHealth
I agree that PhilHealth, as the implementer of the NHIP, should continue providing FP to all Filipinos by reimbursing claims. PHILHEALTH SHOULD NOT DENY CLAIMS JUST SO IT CAN PRESERVE FUNDS and have a longer actuarial life. IMHO, PhilHealth's role as a strategic purchaser of healthcare services/goods is the fulcrum that balances the health and … Continue reading Government should provide financial support to PhilHealth
Principle behind IRM is good
During the Committee Hearing on August 17, Marikina Rep. Quimbo was surprised to know that hospitals are allowed to use funds from the Interim Reimbursement Mechanism (IRM) for other operational expenses (e.g. salary). Let me reiterate that the same mechanism is expected when "prospective payments" (in the form of global budgets) will be provided to hospitals … Continue reading Principle behind IRM is good
Congressional hearing: Corruption allegations against PhilHealth
Congressional Hearing 5 August 2020 1) I do not agree with Cong. Defensor when he said that investing in an IT system while still using the All Case Rate (ACR) system will "computerize" corruption in PhilHealth. Regardless of the provider payment system, an IT system will actually help the Corporation and health care providers … Continue reading Congressional hearing: Corruption allegations against PhilHealth
On the corruption allegations against PhilHealth
I get our anger and frustration over the issue. But the claims forms (CF1, CF2, CF3, CF4) are not there to make it "easier" for PhilHealth to pursue corrupt practices. Actually, the forms are there to safeguard the interests of PhilHealth members by allowing the hospital to declare that the standards of care have been … Continue reading On the corruption allegations against PhilHealth
#NoOneLeftBehind: Modify the HTA process for rare diseases
How do we shape a future with no one left behind? In many countries, health technology assessment (HTA) is a relevant consideration for the distribution of limited resources and is used to decide whether a health technology should be reimbursed or not. In the Philippines, under the Universal Health Care (UHC) Act, only health technologies … Continue reading #NoOneLeftBehind: Modify the HTA process for rare diseases
Stepwise Approach to Address the Nursing Shortage in Critical Care Settings
With limited manpower and resources, hospitals can only do so much in a pandemic. Sadly, the country is still in the pandemic phase of the COVID-19 outbreak and more cases are expected to be confirmed in the following weeks. The Department of Health (DOH) has recently identified six areas in the Visayas as emerging COVID-19 … Continue reading Stepwise Approach to Address the Nursing Shortage in Critical Care Settings
PhilHealth should provide incentives to eliminate out-of-pocket expenses
PhilHealth has instituted a no copayment policy for its benefit packages for the diagnosis and management of COVID-19. The costing of these benefit packages is a result of an iterative process involving data collection, stakeholder consultations, and data analysis. As such, we can say that the “maximum” health care cost for a specific service (e.g. … Continue reading PhilHealth should provide incentives to eliminate out-of-pocket expenses
Pandemic Financing: How the World is Funding the COVID-19 Response (Part 3)
What mechanisms are available to fund the pandemic response? The Ebola crisis in West Africa in 2014 highlighted the difficulty in rapidly organizing funding for an outbreak, especially among economically vulnerable countries. To address this and to prevent future financial catastrophes, several financing mechanisms have been presented to countries. These mechanisms aim to fund the … Continue reading Pandemic Financing: How the World is Funding the COVID-19 Response (Part 3)
Pen Point 51
The deluge of health information poses a great challenge to patients, especially if the information cannot be critically analyzed and synthesized. Therefore, it is incumbent for health care providers to examine and integrate into a coherent whole all the pieces of evidence coming from disparate sources, and help patients make sense of the rapidly changing … Continue reading Pen Point 51
Pens & Needles 