PhilHealth releases P257.6 million to boost primary care service delivery thru Konsulta

The Philippine Health Insurance Corporation (PhilHealth) announced that it 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 expanded primary care benefit package or the Konsultasyong Sulit at Tama (Konsulta) Package.

According to PhilHealth President and CEO Emmanuel R. Ledesma Jr., the move is expected to help accredited Konsulta facilities under the partner networks to ensure readiness to serve patients availing of Konsulta services from consultations to health screening and assessment, to the dispensing of essential drugs and medicines and laboratory procedures as recommended by qualified physicians.

“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 explained. “This is an investment in the general welfare of the Filipino people. Nakahanda kaming mag-invest sa Konsulta para makaiwas ang marami sa pagkakasakit o maagapan ang karamdaman para hindi na lumala,” he added.

To date, four out of the first seven PCPNs under a sandbox setting have received their capitation funds from the state health insurer, namely Quezon Province, P72.9 million; South Cotabato, P53.9 million; Bataan, P114.7 million; and Baguio City,  P15.9 million.

“These funds were frontloaded, 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 explained.

The PCPN sandbox sites were launched by PhilHealth in June last year through a simple signing ceremony. The partnership aims to strengthen primary care services, digitize patient records and streamline claims processes within select areas. The State Agency has allotted P30 billion this year to intensify the implementation of Konsulta in more participating networks to cover more regions especially in geographically isolated and depressed areas.

“To further improve our reach, we are also actively participating in the LAB for ALL or “Laboratoryo, Konsulta, at Gamot Para sa Lahat” Caravan, the flagship project of First Lady Liza Araneta Marcos,” he reported, noting that in the first 17 caravans held in different parts of Luzon and the National Capital Region as of December 31, 2023, a total of 14,000 beneficiaries have been served and availed of consultations with primary care physicians.  

One Konsulta beneficiary in the person of Chessa Amana from Mati, Davao City expressed her appreciation for the Konsulta program. “Nag avail ako ng Konsulta sa CHO Mati last May at laboratory (CBC, Urinalysis, Stool). Sa pag-avail ko ng Konsulta, naka less ako ng gastos at may ibinigay pa na gamot na libre. Overall, na-satisfied ako sa kanilang serbisyo. Sa non-member, ngayon pa lang magpa rehistro na kayo. Kung may PhilHealth ka, garantisado!”