Bill vs. ACR: Should the government pay for whichever is lower?

"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?

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

Pen Point 49

Various provider payment mechanisms will continue to exist in the country’s health care system. Emphasis is placed, however, on the current movement towards using performance-driven, prospective payments (e.g. Global Budget Payment) based on diagnosis-related groups (DRG). The shift to DRG-based GBP will not be easy. Mechanisms should be in place to avoid underprovision and ensure … Continue reading Pen Point 49

THE CHALLENGE OF ENSURING PHILHEALTH COVERAGE AMONG OFWS

EXECUTIVE SUMMARY In order to reduce the financial uncertainties associated with future illnesses, Overseas Filipino Workers are encouraged to enroll themselves in the national health insurance program. However, not all OFWs are enrolled in the program or are actively paying their premiums. The reasons behind this include limited knowledge about Philhealth and its services. This, … Continue reading THE CHALLENGE OF ENSURING PHILHEALTH COVERAGE AMONG OFWS