Clark, Pampanga — The Unilab Center for Health Policy (UCHP) gathered health officials of local government units (LGUs), healthcare providers and patient groups in the province to a roundtable discussion on October 18 to hear their feedback on the roll out of Philhealth’s Konsultasyong Sulit at Tama (Konsulta) program.
Konsulta, launched nationwide in 2020, is Philhealth’s comprehensive outpatient benefits program that aims to enhance health by preventing chronic illnesses, promoting early detection, and offering affordable medications. Through Konsulta, Filipinos can register with accredited providers to access a range of services including consultations, health risk screenings, 15 laboratory tests, and 21 essential medicines.
Recognizing the importance of Konsulta in achieving universal health care (UHC) in the country, the Unilab Foundation – through UCHP – thought of coming up with the Konsulta Manual of Operations (MOP), a guidebook for healthcare providers and LGUs for Konsulta’s efficient implementation.
Roundtable discussion series
Part of the process of finalizing Konsulta’s MOP is the launch of a series of roundtable discussions titled “Working Towards UHC’s Comprehensive Outpatient Benefit Package” to be held in different parts of the country so all stakeholders can share their inputs in the crafting of the manual. The Pampanga leg is the second stop of the roundtable discussion series, with the first held last September 13 in Metro Manila and attended by over 70 stakeholders from PhilHealth, NCR city health offices, private providers, and patient groups.
“We all have a unique opportunity to address the challenges of primary health care, which has been characterized as fragmented, uncoordinated, and isolated,” said Unilab Foundation Executive Director Atty. Jose Maria Ochave. “In this series of roundtable discussions, we can take small, yet deliberate and steady steps that will advance the ‘health for all’ promise of Universal Health Care.
The current Konsulta Manual of Operations, authored by physician-leaders Dr. Maeda Gonda and Dr. Shirley Domingo, was presented to the attendees, after which they were asked to comment based on their experience on the ground.
The comprehensive guidebook seeks to address implementation challenges by providing a clear, step-by-step guide on key aspects such as membership registration, provider accreditation, and social mobilization. Additionally, the Manual of Operations covers practical aspects of the Konsulta program, including benefits availment, provider billing, payment processes, and information systems, to foster a more structured and efficient approach.
“The Unilab Foundation believes in PhilHealth’s Konsulta, which is why, when it was launched, one of UCHP’s initial priority projects was to develop the Manual of Operations for the Konsulta package,” stated UCHP Program Director Ruben Basa.
Dr. Maria Eufemia Yap, a member of the UCH Advisory Council said public and private health service providers, LGUs, and health leaders who understand their communities best are critical in conveying the government’s UHC efforts in a way that resonates with the people they serve.
Bridging health gaps
With over 2,600 accredited public and private primary care facilities as of April 2024, the Philippine health system is still struggling to meet the ideal ratio of one facility for every 20,000 Filipinos.
Also, according to a study commissioned by UCHP and conducted by Prof. Orville Solon, former Dean of the UP College of Economics; former Prof. Alejandro Herrin, and Dr. Michael Mo, private out-of-pocket payments (OOP) have been consistently the biggest component of healthcare spending through the years.
In 2022, for instance, OOP accounted for 45 percent of the country’s total health expenditure. Studies indicate that Filipinos spend more on inpatient care than outpatient services. Thus, efforts to decrease OOP should be directed at reducing expenses for inpatient care.
This is why UCHP views the Konsulta program as a critical step toward reducing Filipinos’ out-of-pocket health spending and in making health services readily accessible.
“As a country accustomed to fee-for-service healthcare, Filipinos often seek medical attention only when faced with serious health issues. PhilHealth’s Konsulta is shifting this mindset by promoting the importance of proactive healthcare through its comprehensive outpatient benefits program. Konsulta aims to ensure equitable access to quality and affordable healthcare for all Filipinos while protecting them against financial risks,” Basa stressed.