Philippines’ Government Sponsored Health Coverage Program for Poor Households

This is a nuts and bolts case study of the implementation of the government-financed health coverage program (HCP) for poor households in the Philippines. The data and information in this case study largely draws upon the 2011 World Bank Report 'Transforming the Philippine health sector: challe...

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Main Author:	Chakraborty, Sarbani
Format:	Working Paper
Language:	en_US
Published:	World Bank, Washington DC 2013
Subjects:	access to health services access to services adult mortality Adult mortality rate aged anesthesia Basic Needs birth attendant birth attendants capitation capitation payment capitation payments Center for Health child health child health services choice of providers cities citizens clinical services clinics Communicable diseases Community health critical care deaths decision making delivery system Delivery Systems developing countries diphtheria disparities in health Doctors educational services Emergency Obstetric Care equal access families Family Health Family Income fee-for-service fee-for-service basis financial incentives financial protection financial risk financial risk protection financial risks Financing Health Care global budgets Gross Domestic Product Gross National Income gynecology health care Health Care Administration health care centers health care costs health care institutions health care professionals health care services health centers Health Coverage health data health expenditure health expenditures health facilities health financing health financing system Health Information Health Information System health insurance coverage Health Insurance Fund Health Insurance Program health insurance schemes health interventions Health Organization health outcomes health programs health reforms health screening health sector Health Service Health Services health spending health system health systems Health Systems in Transition Health Workers healthcare services HMOs hospital admissions hospital autonomy hospital beds hospital services hospitalization hospitalization costs hospitals household surveys human development human resources human resources development ill health immunization incidence of poverty income income countries infant mortality infant mortality rate infant mortality rates informal payments informal sector informal sector workers Inpatient Care insurance companies lab tests large cities life expectancy Life expectancy at birth live births local population Maternal Care maternal deaths Maternal Health Maternal Health Care maternal mortality medical centers medical equipment medical examination Medical Savings Accounts Medicare medicines Ministry of Health monitoring mechanisms morbidity mortality national government National Health National Health Insurance National Health Service national level Neonatal Care neonatal health nongovernmental organizations nurses Nursing Nursing care Outpatient Services patient patients pediatrics pharmacies pharmacy physician physicians pocket payments pregnant women prenatal care prescription drugs preventive health care primary care primary health care PRIVATE FINANCING private health insurance private hospitals Private Insurance private sector private spending provider payment provision of care provision of health services Public Health Public Health Care public health interventions public health programs Public Health Services Public Hospital public hospitals public providers public sector public services public spending quality of care radiology rural areas rural health units Safe Motherhood screening Secretary of Health Service Delivery service provision service quality social health insurance social health insurance schemes SOCIAL INSURANCE social security Social Welfare surgery TB control teaching hospitals technical assistance tertiary level transportation Tuberculosis under-five mortality unemployment United Nations population estimates universal access urban areas urban poverty use of health services use of resources vaccination workers workforce Xrays
Online Access:	http://hdl.handle.net/10986/13296

id	okr-10986-13296
recordtype	oai_dc
spelling	okr-10986-132962017-12-14T08:52:37Z Philippines’ Government Sponsored Health Coverage Program for Poor Households Chakraborty, Sarbani access to health services access to services adult mortality Adult mortality rate aged anesthesia Basic Needs birth attendant birth attendants capitation capitation payment capitation payments Center for Health child health child health services choice of providers cities citizens clinical services clinics Communicable diseases Community health critical care deaths decision making delivery system Delivery Systems developing countries diphtheria disparities in health Doctors educational services Emergency Obstetric Care equal access families Family Health Family Income fee-for-service fee-for-service basis financial incentives financial protection financial risk financial risk protection financial risks Financing Health Care global budgets Gross Domestic Product Gross National Income gynecology health care Health Care Administration health care centers health care costs health care institutions health care professionals health care services health centers Health Coverage health data health expenditure health expenditures health facilities health financing health financing system Health Information Health Information System health insurance coverage Health Insurance Fund Health Insurance Program health insurance schemes health interventions Health Organization health outcomes health programs health reforms health screening health sector Health Service Health Services health spending health system health systems Health Systems in Transition Health Workers healthcare services HMOs hospital admissions hospital autonomy hospital beds hospital services hospitalization hospitalization costs hospitals household surveys human development human resources human resources development ill health immunization incidence of poverty income income countries infant mortality infant mortality rate infant mortality rates informal payments informal sector informal sector workers Inpatient Care insurance companies lab tests large cities life expectancy Life expectancy at birth live births local population Maternal Care maternal deaths Maternal Health Maternal Health Care maternal mortality medical centers medical equipment medical examination Medical Savings Accounts Medicare medicines Ministry of Health monitoring mechanisms morbidity mortality national government National Health National Health Insurance National Health Service national level Neonatal Care neonatal health nongovernmental organizations nurses Nursing Nursing care Outpatient Services patient patients pediatrics pharmacies pharmacy physician physicians pocket payments pregnant women prenatal care prescription drugs preventive health care primary care primary health care PRIVATE FINANCING private health insurance private hospitals Private Insurance private sector private spending provider payment provision of care provision of health services Public Health Public Health Care public health interventions public health programs Public Health Services Public Hospital public hospitals public providers public sector public services public spending quality of care radiology rural areas rural health units Safe Motherhood screening Secretary of Health Service Delivery service provision service quality social health insurance social health insurance schemes SOCIAL INSURANCE social security Social Welfare surgery TB control teaching hospitals technical assistance tertiary level transportation Tuberculosis under-five mortality unemployment United Nations population estimates universal access urban areas urban poverty use of health services use of resources vaccination workers workforce Xrays This is a nuts and bolts case study of the implementation of the government-financed health coverage program (HCP) for poor households in the Philippines. The data and information in this case study largely draws upon the 2011 World Bank Report 'Transforming the Philippine health sector: challenges and Future Directions' (Chakraborty et al. 2011), and technical work undertaken for World Bank support to the Government of the Philippines (GOP) for universal health coverage (UHC) in the Philippines.2 The aim of the case study is to understand how the HCP was implemented, what worked and did not work, and how it impacted expected results under the HCP. In 1996, similarly to many low- and middle-income countries, the Philippines introduced a demand-side program for poor households (the Sponsored Program). The objective was to improve access of poor households to needed health services without experiencing a financial burden. Unlike many countries, where such programs are stand alone, in the case of the Philippines it was integrated into the National Health Insurance Program (NHIP). This is a sound design feature from the perspective of providing optimal risk pooling and redistribution, and the Philippines is a model for other countries implementing similar schemes for poor households. The national government has included financing for poor households in the medium-term national expenditure program, so there is no danger of uncertainty in financing. PhilHealth is incrementally strengthening its contract implementation and monitoring mechanisms. The main challenge now facing the HCP is whether these revamped efforts will be able to quickly address the problem of lack of access to quality and affordable services for poor households. There are supply side constraints, facilities will need to be upgraded to obtain Philhealth accreditation. Accredited health facilities will have to be held accountable for delivering services and where public services are not available, mechanisms for incentivizing the private sector for outreach to poor households will have to be deployed. Much depends on Phil Health's capacity as an effective purchaser of health services. Local government unit (LGU) facility capacity to respond to revamped PhilHealth incentives is another bottleneck. The other challenge is whether the Department of Health and PhilHealth will be able to quickly build the monitoring and evaluation systems needed to track HCP implementation and make the necessary in-flight adjustments in implementation in a timely manner. 2013-05-06T15:08:57Z 2013-05-06T15:08:57Z 2013-01 http://hdl.handle.net/10986/13296 en_US UNICO Studies Series;No. 22 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington DC Publications & Research :: Working Paper Publications & Research East Asia and Pacific Philippines
repository_type	Digital Repository
institution_category	Foreign Institution
institution	World Bank
building	World Bank Open Knowledge Repository
collection	Online Access
language	en_US
topic	access to health services access to services adult mortality Adult mortality rate aged anesthesia Basic Needs birth attendant birth attendants capitation capitation payment capitation payments Center for Health child health child health services choice of providers cities citizens clinical services clinics Communicable diseases Community health critical care deaths decision making delivery system Delivery Systems developing countries diphtheria disparities in health Doctors educational services Emergency Obstetric Care equal access families Family Health Family Income fee-for-service fee-for-service basis financial incentives financial protection financial risk financial risk protection financial risks Financing Health Care global budgets Gross Domestic Product Gross National Income gynecology health care Health Care Administration health care centers health care costs health care institutions health care professionals health care services health centers Health Coverage health data health expenditure health expenditures health facilities health financing health financing system Health Information Health Information System health insurance coverage Health Insurance Fund Health Insurance Program health insurance schemes health interventions Health Organization health outcomes health programs health reforms health screening health sector Health Service Health Services health spending health system health systems Health Systems in Transition Health Workers healthcare services HMOs hospital admissions hospital autonomy hospital beds hospital services hospitalization hospitalization costs hospitals household surveys human development human resources human resources development ill health immunization incidence of poverty income income countries infant mortality infant mortality rate infant mortality rates informal payments informal sector informal sector workers Inpatient Care insurance companies lab tests large cities life expectancy Life expectancy at birth live births local population Maternal Care maternal deaths Maternal Health Maternal Health Care maternal mortality medical centers medical equipment medical examination Medical Savings Accounts Medicare medicines Ministry of Health monitoring mechanisms morbidity mortality national government National Health National Health Insurance National Health Service national level Neonatal Care neonatal health nongovernmental organizations nurses Nursing Nursing care Outpatient Services patient patients pediatrics pharmacies pharmacy physician physicians pocket payments pregnant women prenatal care prescription drugs preventive health care primary care primary health care PRIVATE FINANCING private health insurance private hospitals Private Insurance private sector private spending provider payment provision of care provision of health services Public Health Public Health Care public health interventions public health programs Public Health Services Public Hospital public hospitals public providers public sector public services public spending quality of care radiology rural areas rural health units Safe Motherhood screening Secretary of Health Service Delivery service provision service quality social health insurance social health insurance schemes SOCIAL INSURANCE social security Social Welfare surgery TB control teaching hospitals technical assistance tertiary level transportation Tuberculosis under-five mortality unemployment United Nations population estimates universal access urban areas urban poverty use of health services use of resources vaccination workers workforce Xrays
spellingShingle	access to health services access to services adult mortality Adult mortality rate aged anesthesia Basic Needs birth attendant birth attendants capitation capitation payment capitation payments Center for Health child health child health services choice of providers cities citizens clinical services clinics Communicable diseases Community health critical care deaths decision making delivery system Delivery Systems developing countries diphtheria disparities in health Doctors educational services Emergency Obstetric Care equal access families Family Health Family Income fee-for-service fee-for-service basis financial incentives financial protection financial risk financial risk protection financial risks Financing Health Care global budgets Gross Domestic Product Gross National Income gynecology health care Health Care Administration health care centers health care costs health care institutions health care professionals health care services health centers Health Coverage health data health expenditure health expenditures health facilities health financing health financing system Health Information Health Information System health insurance coverage Health Insurance Fund Health Insurance Program health insurance schemes health interventions Health Organization health outcomes health programs health reforms health screening health sector Health Service Health Services health spending health system health systems Health Systems in Transition Health Workers healthcare services HMOs hospital admissions hospital autonomy hospital beds hospital services hospitalization hospitalization costs hospitals household surveys human development human resources human resources development ill health immunization incidence of poverty income income countries infant mortality infant mortality rate infant mortality rates informal payments informal sector informal sector workers Inpatient Care insurance companies lab tests large cities life expectancy Life expectancy at birth live births local population Maternal Care maternal deaths Maternal Health Maternal Health Care maternal mortality medical centers medical equipment medical examination Medical Savings Accounts Medicare medicines Ministry of Health monitoring mechanisms morbidity mortality national government National Health National Health Insurance National Health Service national level Neonatal Care neonatal health nongovernmental organizations nurses Nursing Nursing care Outpatient Services patient patients pediatrics pharmacies pharmacy physician physicians pocket payments pregnant women prenatal care prescription drugs preventive health care primary care primary health care PRIVATE FINANCING private health insurance private hospitals Private Insurance private sector private spending provider payment provision of care provision of health services Public Health Public Health Care public health interventions public health programs Public Health Services Public Hospital public hospitals public providers public sector public services public spending quality of care radiology rural areas rural health units Safe Motherhood screening Secretary of Health Service Delivery service provision service quality social health insurance social health insurance schemes SOCIAL INSURANCE social security Social Welfare surgery TB control teaching hospitals technical assistance tertiary level transportation Tuberculosis under-five mortality unemployment United Nations population estimates universal access urban areas urban poverty use of health services use of resources vaccination workers workforce Xrays Chakraborty, Sarbani Philippines’ Government Sponsored Health Coverage Program for Poor Households
geographic_facet	East Asia and Pacific Philippines
relation	UNICO Studies Series;No. 22
description	This is a nuts and bolts case study of the implementation of the government-financed health coverage program (HCP) for poor households in the Philippines. The data and information in this case study largely draws upon the 2011 World Bank Report 'Transforming the Philippine health sector: challenges and Future Directions' (Chakraborty et al. 2011), and technical work undertaken for World Bank support to the Government of the Philippines (GOP) for universal health coverage (UHC) in the Philippines.2 The aim of the case study is to understand how the HCP was implemented, what worked and did not work, and how it impacted expected results under the HCP. In 1996, similarly to many low- and middle-income countries, the Philippines introduced a demand-side program for poor households (the Sponsored Program). The objective was to improve access of poor households to needed health services without experiencing a financial burden. Unlike many countries, where such programs are stand alone, in the case of the Philippines it was integrated into the National Health Insurance Program (NHIP). This is a sound design feature from the perspective of providing optimal risk pooling and redistribution, and the Philippines is a model for other countries implementing similar schemes for poor households. The national government has included financing for poor households in the medium-term national expenditure program, so there is no danger of uncertainty in financing. PhilHealth is incrementally strengthening its contract implementation and monitoring mechanisms. The main challenge now facing the HCP is whether these revamped efforts will be able to quickly address the problem of lack of access to quality and affordable services for poor households. There are supply side constraints, facilities will need to be upgraded to obtain Philhealth accreditation. Accredited health facilities will have to be held accountable for delivering services and where public services are not available, mechanisms for incentivizing the private sector for outreach to poor households will have to be deployed. Much depends on Phil Health's capacity as an effective purchaser of health services. Local government unit (LGU) facility capacity to respond to revamped PhilHealth incentives is another bottleneck. The other challenge is whether the Department of Health and PhilHealth will be able to quickly build the monitoring and evaluation systems needed to track HCP implementation and make the necessary in-flight adjustments in implementation in a timely manner.
format	Publications & Research :: Working Paper
author	Chakraborty, Sarbani
author_facet	Chakraborty, Sarbani
author_sort	Chakraborty, Sarbani
title	Philippines’ Government Sponsored Health Coverage Program for Poor Households
title_short	Philippines’ Government Sponsored Health Coverage Program for Poor Households
title_full	Philippines’ Government Sponsored Health Coverage Program for Poor Households
title_fullStr	Philippines’ Government Sponsored Health Coverage Program for Poor Households
title_full_unstemmed	Philippines’ Government Sponsored Health Coverage Program for Poor Households
title_sort	philippines’ government sponsored health coverage program for poor households
publisher	World Bank, Washington DC
publishDate	2013
url	http://hdl.handle.net/10986/13296
_version_	1610775236583620608

Philippines’ Government Sponsored Health Coverage Program for Poor Households

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