The Call for Proposal for the “Evaluation of the Healthcare Provider Performance Assessment System (HCPPAS)” project is NOW OPEN.

Interested proponents may now submit their proposal through the PCHRD Project Management System (https://projects.pchrd.dost.gov.ph/index.php/pms-home) on or before January 30, 2024.

Background & Rationale

The Revised Implementing Rules and Regulations (IRR) of the National Health Insurance Act of 2013 of RA 7875 as amended by RA 9241 and RA 10606 mandates PhilHealth to develop and implement a performance monitoring system for all health care providers (HCPs) and perform post-audit on the quality of services rendered by them.  

In 2015 the HealthCare Provider Performance Assessment System (HCPPAS) was established in order to ensure that reimbursements made to accredited health care providers (HCPs) were based on the principles of accessible, safe, quality and affordable health care to Filipinos. 

It utilizes various approaches and tools in evaluating two domains of a health care insurance system, namely, the quality of healthcare and financing protection.  Ultimately, the domain findings are subjected to performance assessment, with validations on patient satisfaction, motions for improvements, or a metes and bounds decision on offenses against the National Health Insurance Program (NHIP).  

Fast forward, the Universal Health Care Act of 2019 promulgates the submission by all public and private health-related entities of health and health-related data to PhilHealth as guide in research and policy-making.  This redounds to the readiness of the HCPPAS to accommodate the statute.  After more than five years of implementation, the question of whether the HCPPAS program is acclimatized to the UHC principles and suitable for assessing healthcare quality needs to be addressed.

This study, therefore, intends to evaluate the effectiveness of HCPPAS program in its ability to measure the performance of HCPs according to the quality of healthcare and financing protection.  The study design should be comprehensive enough in capturing the adequacy, appropriateness, and reliability of the HCPPAS monitoring concept, its design or structure, methods and tools, including the systems for data analysis, reporting and feedbacking, and the time and resources involved.

———————————————

For more information, please see the enclosed Terms of Reference at https://bit.ly/TOR_HCPPAS.

Should you have further inquiries or concerns, you may contact us through philhealthstudies@pchrd.dost.gov.ph.