Philhealth presentation

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  • Protection from financial impacts of health care use by improving benefit delivery ratio of the NHIP Upgrading of government-owned and operated hospitals and health facilities.
  • Improving health is central to the Millennium Development Goals (MDG)
  • The new corporate website, www.philhealth.gov.ph , which promises to be more user-friendly but is still packed with the necessary information on the National Health Insurance Program that a PhilHealth stakeholder needs. The new website opens to three major sections, namely, MEMBERS, CORPORATE PARTNERS and ONLINE SERVICES. The MEMBERS section leads site visitors to the five (5) member-categories, while the CORPORATE PARTNERS section leads to our accredited facilities, health care professionals, collecting agents, as well as to private partners. Finally, the ONLINE SERVICES features several electronic facilities that include the eRegistration, eClaims, and PhilGIS.
  • Pending the complete payment mechanism of case payment for all types of illness, Philhealth will still continue the fee for service payment. Fee for service reimbursements is the kind of health insurance policy wherein payment to health care providers is made at the time of service. The benefits are subject to some limits which differ based on the level of the health care facility (Level 1, 2, 3, 4) and the severity of the cause of admission (Case type A, B, C, D)
  • Philhealth presentation

    1. 1. PhilHealth :Achieving Universal Health Care for All Filipinos Gregorio C. RullodaVice-President and Spokesperson Corporate Affairs Group
    2. 2. Strategic Thrusts - UHC1. Financial risk protection by expanding NHIP enrollment and benefit delivery 2. Improved access to quality hospitals and health care facilities
    3. 3. Strategic Thrusts - UHC3. Attainment of the health-related MDGs: reduction of maternal and child mortality, morbidity and mortality from TB and malaria and the prevalence of HIV/AIDS 3. Preparedness from emerging disease trends 4. Prevention and control of non- communicable diseases
    4. 4. PhilHealth’s ROLE & GOAL Vision Bawat Pilipino Miyembro Bawat Myembro Protektado Kalusugan Natin Segurado Mission "Sulit na Benepisyo sa Bawat Miyembro, Dekalidad na Serbisyo para sa Lahat"
    5. 5. Specific Goals
    6. 6. Bawat Pilipino, MiyembroSOCIAL SOLIDARITY: Bayanihan into the National Health InsuranceProgram where the healthy, wealthy and unaffected look after thesick, poor and afflicted. No one is excluded, everybody are entitled to the care of the nation. Allare members and all have rights & responsibilities, and being a contributingmember alone allows everybody to fulfill their responsibilities. Employees Individually Sponsored Members Paying Members Lifetime Members OFWs
    7. 7. Bawat Pilipino, MiyembroWho are the qualified dependents…? Parents who are 60 years Spouse of the member old & above who are not members Children who are below 21 years old
    8. 8. Bawat Pilipino, Miyembro “Sa kalusugan naman po: Nang dumating tayo, animnapu’t dalawang porsiyento lamang ng mga Pilipino ang naka-enrol sa PhilHealth. …..Ngayon po, 85 percent ng lahat ng mamamayan, miyembro na nito. Ang ibig pong sabihin, 23.31 million na Pilipino ang naidagdag sa mga saklaw ng 85% PhilHealth mula nang bigyan tayo ng mandato. “
    9. 9. Bawat Pilipino, Miyembro Members Registered Sector Dependents and Members DependentsEmployed 11.36 13.69 25.05 Government 2.03 4.00 6.03 Private 9.33 9.69 19.02Sponsored Members 10.06 29.83 39.89Individually-Paying 4.74 6.07 10.81Lifetime Members 0.61 0.42 1.03Overseas Workers 2.63 2.55 5.18Total 29.40 52.56 81.96
    10. 10. Bawat Pilipino, Miyembro Bringing information closer to Members and Empowering Members
    11. 11. Bawat Pilipino, Miyembro Bringing information closer to Members and Empowering Members
    12. 12. Bawat Pilipino, MiyembroThe Corporate Website
    13. 13. Bawat Pilipino, Miyembro Bringing information closer to Members and Empowering Members PhilHealth Taps Social Media for SHI Advocacy www.facebook.com/philhealth email.actioncenter@philhealth.gov.ph teamphilhealth From: carina_mana@yahoo.com.ph Sent: Thursday, June 07, 2012, 3:27 PM To: actioncenter@philhealth.gov.ph Subject: PHILHEALTH number verification Hi, This is so great, I hope PAGIBIG service will follow your footsteps in serving their people. Anyways, I will continue with my contributions starting this month and again thank you very much for your immediate assistance on this matter  Cheeers!
    14. 14. Bawat Pilipino, Miyembro  Bringing information closer to members and Empowering members
    15. 15. Bawat Pilipino, Miyembro Bringing information closer to members and Empowering members
    16. 16. Bawat Pilipino, Miyembro  Bringing information closer to Members and Empowering membersPhilHealth Launched SHInES in Iloilo City PhilHealth SHInES at House of Representatives
    17. 17. Bawat Pilipino, Miyembro  Bringing information closer to Members, Empowering themPhilHealth Expo Launches the"Be PhilHealth Now" Campaign
    18. 18. Bawat Pilipino, Miyembro Bringing information closer to Members and Empowering MembersPhilHeaths e-Innovations forHealth Launched Electronic Payment Facilities Enables individuals to register Remittance-By-Air thru text online Enables employers to Registration, billing and query of post payments of their Organized Groups employees on real time
    19. 19. Bawat Pilipino, Miyembro Bringing information closer to Members and Empowering MembersPhilHeaths e-Innovations forHealth Launched Facility for checking membership status of Facility for checking Sponsored Members under the NHTS-PR eligibility of membership during benefits availment and filing of claims by HCPs Facility for viewing the locations of health facilities and visualization of various corporate data using maps
    20. 20. Bawat Pilipino, Miyembro Bringing information closer to Members and empowering MembersPhilHeath’s presence and visibilityin various fora, conventions,special events and similar 2012 Kabisig Nationalactivities Government Expo Umagang Kay Ganda Kapamilya Services DZMM’s "Takbo para sa Karunungan" 2nd Philippine Print Media Congress Iloilo Charter Day Region 6 Inter Agency Tournament
    21. 21. • Bawat Miyembro, Protektado PhilHealth’s Deliverable to the Society: Financial Risk Protection  Every Filipino can get financial assistance, have access to excellent providers where health care is paid for, use the assistance when needed, and receive significant support
    22. 22. Bawat Miyembro, Protektado To have the opportunity to get financial assistance whenever it might be needed ANG PREMIUM AY ABOT KAYA!!! Sa halagang P3.33 /day or P100.00/month o depende sa buwanang kita para sa mga empleyado at professionals
    23. 23. Bawat Miyembro, Protektado To have accessibility to health professionals and facilities where quality health care is paid for;
    24. 24. Bawat Miyembro, Protektado To actually use the assistance when needed 11% Out of Pocketwhen doing so, to 9% National receive a 13% 54% significant amount Local 13% of support Social Health Insurance Others
    25. 25. BENEFITS Hospital
    26. 26. BENEPISYO sa PHILHEALTH In-Patient Care Hospital Out-Patient CareHealth Center
    27. 27. Bawat Miyembro, Protektado Assistance to members at the point of service
    28. 28. Bawat Miyembro, Protektado Easy access to members and stakeholders in benefit availmentPhilHeaths e-Innovations forHealth Launched Facility for checking membership status of Facility for checking Sponsored Members under the NHTS-PR eligibility of membership during benefits availment and filing of claims by HCPs Facility for viewing the locations of health facilities and visualization of various corporate data using maps
    29. 29. Kalusugan Natin, Segurado Adress inequities in Health No Filipino will ever be financially afraid of getting sick, and that no one will left behind in the race toward universal health care and financial risk protection PhilHealth needs to and will leverage its purchasing power to help break the silos and foster increased collaboration
    30. 30. Kalusugan Natin, Segurado How to use PhilHealth’s purchasing power?  Use Performance Commitment Contracts to ensure that health facilities are safe and high quality; Provide incentives to ensure that health human resource is adequate in number, purposely distributed and properly compensated
    31. 31. Kalusugan Natin, Segurado How to use its purchasing power? Negotiate for lower costs and charges of health care goods and services
    32. 32. Kalusugan Natin, Segurado PhilHealth want to change HOW health care services are rendered by providers with care and received by members with pride Case payment for all diseases – provides clear, explicit and predictable financial support; Case Rates - Since September 1, 2011, there were 11 medical cases and 12 surgical procedures being paid through case rate
    33. 33. Kalusugan Natin, Segurado  No Balance Billing Policy (SAPAT NA ANG BAYAD NG PHILHEALTH) “…Ito po ang proseso ng pagpapagamot para sa kanila: Papasok ka sa alinmang ospital ng gobyerno. Ipapakita mo ang iyong PhilHealth card. Magpapagamot ka. At uuwi kang maginhawa nang walang inilabas ni isang kusing…”
    34. 34. PHILHEALTH_oct16 FIN_mpeg2video.mpg
    35. 35. Thank You!Panatag ang Loob at MasayangPamilya Kapag Naka PhilHealth

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