PhilHealth pays P257M to primary care providers

PhilHealth file photo

The Philippine Health Insurance Corp. (PhilHealth) has released more than P257 million representing the first tranche of capitation payments to primary care provider networks (PCPNs) to boost the nationwide implementation of its comprehensive outpatient benefits package, called Konsultasyong Sulit at Tama (right and reasonable consultation), or Konsulta.

According to PhilHealth president and CEO Emmanuel Ledesma Jr., the move was expected to help accredited facilities under the partner networks to ensure readiness to serve patients availing of Konsulta services.

As of Wednesday, four out of the first seven PCPNs under a “sandbox” setting have received their capitation funds from PhilHealth. “Sandbox” setting is testing basis in preselected areas that allows advanced payments or front-loading of funds even before services are rendered.

These were the local governments in Quezon province, P72.9 million; South Cotabato, P53.9 million; Bataan, P114.7 million; and Baguio City, P15.9 million.

The other PCPNs were the local government of Guimaras province, and private health-care providers LiFE group and QualiMed.

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“This initial wave of releases will definitely hasten enlistment of members under the networks’ catchment areas and facilitate patients being seen by the providers that they have chosen,” Ledesma said in a statement on Wednesday. Besides Valentine’s Day, on Feb. 14, PhilHealth celebrated its 29th anniversary.

“These funds were front-loaded, meaning we have advanced the funding even before they render the services. This way, these networks can mobilize these to augment health resources and even ground personnel so they can serve patients adequately especially those underserved communities and the vulnerable segments,” Ledesma said. INQ