DOH to Utilize POC in Hospitals for Attainment of 100% Enrollment of Filipinos in PhilHealth

The Point-Of-Care (POC) Enrollment Program can be a key to attainment of the 100 percent Philippine Health Insurance Corp. (PhilHealth) coverage for all Filipinos pushed by President Rodrigo R. Duterte in his first State of the Nation Address (SONA).

Department of Health (DOH) Secretary Paulyn Ubial, through POC , said the department could reach all Filipinos and enroll them to PhilHealth to fulfil the pronouncement of the President stated in the 1 hour and 32 minutes speech he delivered Monday afternoon at the House of Representatives in Batasan Complex, Quezon City.

At present, PhilHealth still need to enroll 8 percent of the population to attain 100 percent full coverage, wherein the current number of Filipinos covered was at 92 percent as of December 2015.

“We will be continuing this point-of-care enrollment program. So if the patient comes to a hospital and they don’t have PhilHealth, they are being enrolled automatically by the hospital itself,” said Ubial in an interview.

Under the POC, the patient simply needs to pass the medical social worker’s assessment (interview) to become a Sponsored member, with the hospital shouldering the annual premium contribution of Php 2,400 to PhilHealth.

The POC was launched in November 2013 and was initially implemented in 85 retained hospitals of the Department of Health (DOH) nationwide.

The program aims to provide an effective mechanism to cover those from the C to D segments of the population, who are confined in government hospitals but are either non-members or existing members but lacking qualifying contributions.

Those listed to it are usually not included in the indigents surveyed under the National Household Targetting System for Poverty Reduction (NHTS-PR) of the Department of Social Welfare and Development (DSWD).

Ubial added that they would also seek the support of all local government units (LGUs) in the country to make POC more effective in helping Filipinos.

“We’re also doing it through our LGUs. If it is in a DOH-run hospital wherein the patient (without PhilHealth coverage premium), the (DOHO hospital will pay the premium. But for LGUs, it is the LGU that will pay for the premium of these patients,” said Ubial.

The DOH said that aside from attainment of the universal health insurance coverage for all Filipinos, improvement of the utilization and availment of health services should actually geared toward the poor or disadvantaged sectors of the society which President Duterte wanted to be the hallmark of his administration.

By doing, so the PhilHealth policies is currently being reviewed to find ways in ensuring that the dream for “zero” out-of-pocket-expenses, especially among the poor, could be made a reality aside from implementing the “No Balance Billing” policy in the hospital wherein the full need pay anything.

With no added expenses, the cost of hospitalization and the health-seeking behavior of the poor can be improve also at the same time because they will immediately seek hospital care in the preventive state rather than on the curative stage wherein their illnesses/diseases were at the worst level because of fear of expenses.

One thing being looked at by the Health Chief as a way of improving the benefits of PhilHealth is if it can also cover the transportation cost incurred in bringing the patient to the hospital and until he/she returns home after the treatment.

The added “cost” contributes to the fact that many of them seek assistance also to the crisis intervention unit of DSWD because of the expenses in the cure of their sickness/diseases.

Based on the records of CIU of DSWD under the Protective Service Bureau section, bulk of assistance was due to health assistance (in the form of financial assistance/food assistance) sought by families of patient affected by the hospitalization painful costs. (PNA) RMA/LSJ