Global partnerships in health innovation (1)
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The document discusses plans for achieving Universal Health Coverage in the Philippines by 2016. Key points include: - Expanding PhilHealth coverage to insure an additional 5.6 million poor and near-poor families and improving benefit packages. - Scaling up preventive health programs, deploying more health workers, and upgrading health facilities to ensure all Filipinos have access to quality care. - The total additional funding needed from 2013-2016 is estimated to be PHP 137.2 billion to fully implement Universal Health Coverage.
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Global partnerships in health innovation (1)
- 1. Innovation in Access to Healthcare The Social Contract through Universal Health Care Teodoro J. Herbosa, MD Undersecretary Department of Health
- 2. Investing in Filipinos, especially the poor Universal Health Care Education Housing Good Govern- ance
- 3. Strengthen Preventive & Promotive Care Governance Reforms for Hospital Upgrade Health Facilities Improve Policy, Regulation and Sector Management DOH Expand Coverage Improve Benefits 5.2M to 14.7M families UHC: synchronized reforms in DOH and PhilHealth PhilHealth
- 4. UHC financing requirements What we have (DBM Forward Estimates, in billion PHP) What we need (DOH estimates, in billion PhP) 2013 2014 2015 2016 Total A Preventive & Promotive Health Programs 5.8 12.3 5.5 4.3 27.9 B PhilHealth Premiums 12.6 12.6 18.9 18.9 63.0 C Hospital Operations 14.4 14.9 15.4 15.9 60.6 D Health Facilities Enhancement Program 13.6 10.6 10.2 10.7 45.1 E Policy and Regulation and Sector 7.6 7.9 8.2 8.6 32.3 TOTAL 54.0 58.3 58.2 58.4 228.9 2013 2014 2015 2016 Total A Preventive & Promotive Health Programs 21.1 21.9 22.8 23.7 89.5 B PhilHealth Premiums 25.9 25.9 38.9 38.9 129.6 C Hospital Operations 14.4 14.9 15.4 15.9 60.6 D Health Facilities Enhancement Program 13.6 17.7 10.6 7.1 49.0 E Policy and Regulation and Sector 8.8 9.2 9.5 9.9 37.4 TOTAL 83.8 89.6 97.2 95.5 366.1
- 5. Where are we in UHC implementation? Increase in PhilHealth enrolment rate •100% coverage of NHTS-PR identified poorest households (14.7m families/40 M with annual premium P 2,400 or totalling P 35.7billion. •2013, enrolment increased to 82.4M •200+%inc in enrolment of the poor universal coverage achieved Introduction of More PhilHealth Benefits •Primary Care Benefit Package •Case rates for most common medical and surgical conditions and selected catastrophic diseases with “No Balance Billing” Policy for the poor or Sponsored members Total PhilHealth Enrollment Column1 Year Population Year Population Year Population Year Population 95.8 M 65% 17%
- 6. Health Financing • Implementation of Primary Care Benefit Packages (PCB): a. PCB 1 – consultation, screening and diagnostics for NCDs i.e. Visual Inspection Using Acetic Acid Wash (VIA) b. PCB 2 - management and provision of medications for NCDs i.e. Complete Treatment Packs for DM and HPN • Z Packages for catastrophic illnesses i.e. breast cancer and ALL • Case payment rates
- 7. What needs to be done to achieve UHC? 2012 2013 2014 2015 2016 Refocus preventive and promotive services to NHTS-PR/CCT families; Deploy Community Health Teams (CHTs) to increase use of services CHTs deployed Rnheals nurses/ others deployed 50,000 22,500 100,000 22,500 100,000 11,000 100,000 11,000 100,000 11,000 Enroll/register, inform, and guide families on their PhilHealth benefits/entitlements Households covered by PhilHealth Poorest identified using NHTS- PR *Catastrophic care package introduced Expand to next poorest (Q2); Universal Coverage *Catastrophic care package fully implemented Universal Coverage 14.7m poorest families Universal Coverage 14.7m poorest families Universal Coverage 14.7m poorest families Upgrade quality of care at health facilities Facilities upgraded RHUs/Main Health Centers – 2,243 District Hospitals – 403 Provincial and City Hospitals – 100 DOH-retained Hospitals – 37* *Will take more than 3 years Note: Incentives to sustain delivery of quality care introduced by 2014 Maintainenance and upkeep of upgraded facilities; construction of new ones to ensure service capacity
- 8. UHC implementation status Treatment Pack (Medicines) and Vaccines •Basic medicine packs for outpatient care (antihypertensives, antidiabetic, antibiotics, antiasthma etc.) distributed quarterly to all Rural Health Units nationwide •Rotavirus vaccination for diarrhea for 700,000 poor children •Pneumonia vaccines for 700,000 poor children and 1M senior citizens •Influenza vaccines for senior citizens Health Human Resources Deployed •Doctors to the Barrios: 62 in 2010, 113 in 2011, 221 in 2013 •Nurses (RN Heals): 2010: 12,500, 2011-2012: 22,500 annually •Community Health Teams: 164,456 members deployed in 2012 Health facilities upgraded •3,258 hospitals, rural health units and barangay health stations upgraded and rehabilitated from 2010-2012, P 18 billion spent for infrastructure and equipment
- 9. National Center for Health Promotion NCHP is the Department of Health’s arm in promoting health in settings where people live, work, learn and play.
- 10. Some Health Promotion Activities… • LAKBAY BUHAY KALUSUGAN KALUSUGAN PANGKALAHATAN ON WHEELS - 1 Victory Liner-donated Bus - Transformation of 8 China-donated Mobile Clinic buses to LBK-KP
- 11. Health Promotion & ISO 9001:2008 In the pursuit to continuously improve, meet, and even exceed people’s expectations of a QUALITY MANAGEMENT SYSTEM that enhances health care service delivery...
- 13. • Increase the logistics capacity and lifelines for health sector response: ◦ Emergency communications system ◦ Air Transport to, and within the affected areas ◦ Emergency logistical needs such as generators, hospital tents, etc. • Build resilient health facilities ◦ Hospitals as the last facility standing ◦ Hospitals as hubs for energy, water, logistics, communications, and shelter • Develop self-sufficient teams ◦ Properly equipped Mobile surgical, public health teams ◦ Physically and psychologically prepared teams to withstand the disaster conditions Recommendations for DRRM
- 14. PPP
- 15. 700 Beds70% Sponsored Patients • Cost of treatment is covered by PhilHealth case rates • No co payment by the patient • PhilHealth/Insurer reimburses hospital operator for service Beds Reserved - 490 30% Pay Patients •Patients with co- payment ( i.e. balance exceeding insurance coverage paid by patient) Beds Available - 210 ‘Point of Care’ Patients Service Beneficiaries 7
- 16. Philippine Health Information Exchange
- 18. Department of Health Sin Tax National Budget Foreign Assistance •Health facilities: infrastructure, equipment, operations, human resource •Public health programs: FP, MCH, TB, NCDs, WASH, Health Promotion •PhilHealth PremiumsSUPPLY DEMAND • 4,000 mothers per year saved from deaths due to pregnancy and childbirth • 2 million unwanted pregnancies prevented • 2.5 million children per year immunized • 5.6 million saved from malaria • 14.7million poor families enrolled in PhilHealth and assigned to primary care facility by Community Health Teams • 200 doctors, 2,000 midwives, 11,000 nurses deployed yearly (100% municipalities with health professionals) • 100% of government hospitals able to provide all services at No Balance Billing • 2,783 modernized BHS, RHUs, hospitalsMDGs achieved Poor and near poor financially-protected Affordable and accessible quality care for all Filipinos HEALTHIER FILIPINOS INCREASED PRODUCTIVITY INCLUSIVE GROWTH
- 19. Universal Health Care Better health outcomes Responsive health system Equitable health financing Health Financing Service Delivery Policy, standards and regulation Health Human Resource Health Information Governance for Health
- 20. What full UHC implementation will achieve by 2016 1. Save lives of 16,000 mothers from dying due to pregnancy and childbirth complications 2. Prevent 2M unplanned pregnancies, including abortions 3. Save and protect over 5.6M Filipinos from malaria, dengue and other preventable diseases 4. Immunize 10M children against vaccine preventable diseases 5. Reduce death and disability from non communicable diseases (e.g. heart disease, diabetes, cancers)longer life expectancy at birth 6. Poor and near poor families not pushed to poverty by high cost of health care 7. Access to 2,783 modern community health centers and hospitals
- 21. 0 75 150 225 300 PhilHealth DOH 70.6 66.6 165.9 63 Current Scale Up Fully implementing UHC: Scaling-up programs and resourcing PhilHealth insures an additional 5.6M families with improved package covering all poor and near poor families (from the current 5.2 million poorest) DoH ensures the Philippines attains MDGs, and all Filipinos are provided with the preventive & promotive care fit for a middle income country + 105% + 42%
- 22. Scale up priorities by program Total Gap for Rest of Aquino Administration PHP 137.2 billion PHPBillions 0 35 70 105 140 A. Preventive & Promotive Health Programs E. Policy and Regulation and Sector Management 5.1 3.9 66.6 61.6 Current 2013-16 Scale up 2013-2016