The Philippine Health Insurance Corporation (PhilHealth) will be introducing three benefit packages for  members requiring  mental health, physical rehabilitation, and heart attack treatment. 

Developed from research projects under the PhilHealth STUDIES (Supporting the Thrust for Universal Health Care through Data, Information, and Knowledge Exchange Systems) Program monitored in collaboration with the Department of Science and Technology – Philippine Council for Health Research and Development (DOST-PCHRD), the benefit packages aim to support the realization of the Universal Healthcare (UHC) Law in the country. 

The mental health package incorporates the results of the study conducted by Dr. Lester Sam Geroy of the Alliance for Improving Health Outcomes (AIHO). The package will cover primary and specialist care consultations, diagnostics, and psychiatric and neurologic services, among others. Following the recommendations from the study, the package will be introduced to selected areas in the country prior to implementation to evaluate its provisions. The mental health package is scheduled to be launched within the year. 

Derived from a study led by Dr. Josephine Bundoc of the Physicians for Peace Philippines (PFP), the rehabilitation package can be availed by Filipino adults aged 18 years old and above. The package aims to offer financial protection to patients needing physical and rehabilitation medicine services. This will cover rehabilitation for conditions related to  mobility, self-care, cognition, and communication. This package will be launched by 2024. 

Another benefit package for ST-elevation myocardial infarction (STEMI) was based on a study also led by Dr. Geroy of AIHO and Dr. Eric Oliver Sison of the Philippine Society for Cardiovascular Catheterization. A type of heart attack caused by a blockage in the coronary artery, STEMI is the leading cause of mortality among cardiovascular diseases in the Philippines. (1)  Scheduled for implementation by 2025, the STEMI package will cover services from: the first medical contact phase, acute care phase, to inpatient management and rehabilitation phase. 

PhilHealth Corporate Planning Department Senior Manager Dr. Edwin Orina assures the public that the Corporation has sufficient source of funds for the eventual rollout of the packages:  “Kakayanin po ba ng PhilHealth? I assure you, kakayanin po. Mababa pa po yung ating benefit expense, kesa sa collection natin so napakarami po nating pondo para mabigyan ng kaakibat na budget yung sinasabi po nating mental health, rehabilitation, and of course, the STEMI packages.” (I assure you that PhilHealth is capable of implementing these packages. Our benefit expense is lower than our collection, which means that we have the funds needed to implement the mental health, rehabilitation, and STEMI packages.)

“Through the PhilHealth STUDIES program, we at the DOST-PCHRD together with PhilHealth are working towards formulating healthcare services that are accessible for the Filipino people,” DOST-PCHRD Executive Director Dr. Jaime C. Montoya said. “The anticipated implementation of these packages is proof of how collaborations in research can contribute to the realization of universal healthcare in the country,” he added. 

The PhilHealth STUDIES program and the three benefit packages were featured in the Talakayang HeaRT Beat press conference session last 9 June 2023 at the Prime Hotel, Quezon City. Replay of the event may be accessed through this link. 

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Initiated in 2015, PhilHealth STUDIES is a collaborative grant management program that supports scientific research studies, capacity-building activities, and research utilization projects that are geared towards the production of evidence-based policy recommendations for PhilHealth that will support the implementation of the UHC Law.

References:

1. PhilHealth commissioned research into new insurance coverage for heart diseases