News
PhilHealth Pushes for Better Quality Health Care - July 19, 2006
TRUE to its mandate of ensuring quality health care for all
members of the National Health Insurance Program (NHIP), the
Philippine Health Insurance Corporation (PhilHealth) has adopted
innovative projects that guarantee quality health care.
In a Press Conference at Annabel’s Restaurant this morning,
Dr. Eduardo P. Banzon, PhilHealth Vice President for Health
Finance Policy Services said that PhilHealth is geared towards
implementing new accreditation standards for its partner health
care providers. "We have developed the PhilHealth
Benchbook which is a yardstick against which the quality
of health care rendered by PhilHealth and its accredited institutional
and professional health care providers can be measured",
Banzon stressed.
He added that the PhilHealth Benchbook presents an updated list
of standards and criteria against which health care provider
organizations and professionals are encouraged to assess themselves
prior to applying for accreditation, and more importantly, after
accreditation has been granted by PhilHealth.
Moreover, together with the implementation of the PhilHealth
Benchbook in 2007, PhilHealth will implement the Continuing
Accreditation Project which aims to grant health care
providers ‘continuing accreditation unless revoked’.
This new concept of accreditation aims to establish long- term
relationships with health care providers with the end in view
of nurturing them to be better hospitals. "PhilHealth
recognizes the importance of health care providers since without
them, enrolment with PhilHealth is practically useless since
health care services will be inaccessible," Banzon
pointed out.
Banzon announced that these projects will be implemented as
follows:
| (1) | Appraisal of the first group of ‘Medical Tourism’ Hospitals before the end of 2006; |
| (2) | Initial appraisal of Levels 3 and 4 hospitals in Visayas and Mindanao in 2007; |
| (3) | Appraisal of all National Capital Region (NCR) hospitals using the Benchbook Accreditation Standards before the end of 2007; and |
| (4) | Appraisal of all hospitals using the Benchbook by 2008. |
He also stressed that PhilHealth aims to empower its members
by making fee schedules explicit and by rationalizing the Professional
Fees being collected by health care professionals. This is done
through the Relative Value Scale (RVS),
a systematic listing and coding of surgical procedures where
each procedure is assigned a corresponding Relative Value Unit
(RVU). "With the RVS the reporting of procedures performed
by physicians are simplified and accurately identified. PhilHealth
envisions a National Fee Schedule and this should be done for
the interest of our members."
At the same time, the Health Technology Assessment (HTA)
Forum was published to disseminate information on the
recommendations and evidence reports of drugs that were reviewed,
prepared and translated into policies by the HTA Committee which
is composed of various Specialty Societies and PhilHealth through
its Quality Assurance Research and Policy Development Group.
Banzon said the HTA Forum is a showcase of PhilHealth’s
commitment to quality care and features work resulting from
other programs of HTA, including appraisal and dissemination
of clinical practice guidelines developed by local medical societies
used for reviewing reimbursement claims and evaluation of the
effectiveness and safety of medical and surgical procedures.
To date, eight (8) hospitals have been visited for purposes
of assessing their use of the CPGs.
Banzon pointed out that the prevailing high cost and wide price
variation of drugs impede the access of the greater majority
of Filipinos to timely and quality health care. Many essential
drugs are unaffordable to the average Filipino, thereby depriving
them of health by curtailing treatment, prevention, and control
of illnesses. "This prompted Her Excellency Gloria
Macapagal-Arroyo, to declare in her first SONA, that the nation
shall exhaust its efforts to cutting to half the costs of exorbitantly
priced essential medicines, especially those commonly bought
by the poor, making these more affordable, accessible and available
to the masses. In realizing the President’s directives,
the Department of Health (DOH) and the PhilHealth have embarked
on various strategies to achieve this", Banzon said.
The PhilHealth Vice President said that it all begins with the
public knowing the right price of their medicines at any given
time. This is what a revitalized PhilHealth’s Drug
Price Reference Index (DPRI) provides as a service to
the Filipino citizenry.
"Working under Secretary Duque’s framework of FOURmula
One for Health (F1), both agencies have worked together
with other public agencies, private and international organizations,
consumer groups and the academe to achieve price transparency
and to disseminate this vital information to the public,"
Banzon said.
He explained that the DPRI was developed to help answer the
need of the Filipinos to have access to affordable and quality
drugs. As the largest purchaser of health care, PhilHealth can
help make essential drugs and health care available and affordable.
Through the DPRI, PhilHealth and DOH aim to promote drug price
transparency, rational and fair drug pricing, and rational drug
use.
"This initial listing of prices shall inform the public
of the price range for a select number of essential drugs. PRICE
TRANSPARENCY will be the initial step towards empowering
consumers and improving accessibility to drugs. The consumer
is encouraged to refer to this list when making decisions on
drug purchases. Empowered with this information, the public
shall be able to demand for lower drug prices. PhilHealth will
be vigilant, and will continue to monitor drug prices and recommend
the appropriate prices of drugs. Eventually, a reference price
for all the drugs in the Philippine National Drug Formulary
shall guide drug reimbursements of PhilHealth beneficiaries,
and all other government drug purchases," Banzon concluded.