Neonatal sepsis at bronchial asthma, dagdag na benefit package ng PhilHealth

ni Fely Ng @Bulgarific | June 8, 2024

Hello, Bulgarians! Ang Philippine Health Insurance Corporation (PhilHealth) ay nagpatupad ng isa pang round ng pagpapahusay sa dalawa sa kasalukuyan nitong mga benefit package, sa pagkakataong ito para sa neonatal sepsis at bronchial asthma na tumaas nang husto ng higit sa 100%.

Ang PhilHealth Circulars 2024-0008 at 0009, ang implementing guidelines ng dalawang case rate package na ito, ay nag-uutos na ang lahat ng pasyenteng na-admit noong Mayo 1, 2024 pataas, ay maaaring mapakinabangan ang dagdag na benepisyo sa mga akreditadong health facilities.

Ayon kay PhilHealth President and CEO Emmanuel R. Ledesma Jr., “the PhilHealth Board has approved the increase in package rate for neonatal sepsis to P25,793 from P11,700 and bronchial  asthma in acute exacerbation to P22,488  from P9,000. The increase translates to 120% and 150%, respectively”. 

Ang neonatal sepsis at iba pang nakakahawang kondisyon ay kabilang sa mga pangunahing sanhi ng pagkamatay sa Pilipinas. Noong 2023, nagbayad ang PhilHealth ng P733.86 milyon para sa mahigit 57,000 kaso para sa nasabing kondisyon.

Sa kabilang banda, ang asthma o hika ay nananatiling isang mabigat na karamdaman sa ‘Pinas sa kabila ng mga pagsulong sa medisina. Ang karamihan sa mga Pilipinong may hika ay walang sapat na kontrol sa kanilang mga kondisyon, na nagreresulta sa pagkaospital. 

Batay sa datos ng PhilHealth para sa 2023, ang hika ay nasa walo sa mga nangungunang medical confinement na tinustusan ng state insurer, kung saan P717M ang binayaran para sa mahigit  90,000 kaso ng asthma.

Tinukoy ng PhilHealth ang neonatal sepsis at bronchial asthma bilang mga prayoridad na kondisyon sa rasyonalisasyon ng All Case Rates packages nito upang higit na mapahusay ang financial coverage at mas mababa, kung hindi man maalis ang mga gastusin mula sa bulsa ng mga pasyente.

Paliwanag pa ni Ledesma, “PhilHealth is continuously improving its benefit packages in line with our thrust Pinalawak at mga Bagong Benepisyo para sa Mamamayang Filipino. We are hoping that these enhancements bring positive impact in the behavior of the Filipinos in seeking medical attention. Sa mga nangangailangang magpagamot, huwag na pong magdalawang isip dahil nakaalalay ang PhilHealth sa kanilang gastusing medikal”. 

Hinikayat din ng PhilHealth chief ang lahat ng miyembro na magparehistro sa gusto nilang Konsulta Package Provider para makakuha ng libreng konsultasyon, health screening at assessment, gayundin ang alinman sa 21 essential drugs at gamot at 13 laboratory test na kakailanganin ng kanilang primary care physician.

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PhilHealth increases benefits for neonatal sepsis and bronchial asthma

by Info @Bulgarific | May 29, 2024

Effective May 1, 2024, the Philippine Health Insurance Corporation  (PhilHealth) is implementing another  round of enhancements in two of its  existing benefit packages, this time for  neonatal sepsis and bronchial asthma which have been increased heftily by more  than 100%.  

PhilHealth Circulars 2024-0008 and 0009, the implementing guidelines of these two  case rate packages, prescribe that all  patients admitted on May 1, 2024 onwards  may avail themselves of the increased  benefits in accredited health facilities.  

According to PhilHealth President and CEO Emmanuel R. Ledesma Jr. “the PhilHealth  Board has approved the increase in package rate for neonatal sepsis to  P25,793 from P11,700 and bronchial  asthma in acute exacerbation to P22,488  from P9,000. The increase translates to 120% and 150%, respectively”.  

Neonatal sepsis and other infectious  conditions are among as the leading causes  of neonatal deaths in the Philippines. In  2023, PhilHealth paid P733.86 million for  

more than 57,000 cases for the said  condition.  

On the other hand, asthma remains to be a  high-burden ailment in the Philippines  despite medical advancements. The majority of Filipinos with asthma do not  have adequate control over their  conditions, resulting to confinements. Based on PhilHealth data for 2023, asthma  ranks eight among the top medical confinements paid by the state insurer, where P717 M have been paid for, for more  than 90,000 cases of asthma. 

PhilHealth identified neonatal sepsis and  bronchial asthma as priority conditions in  rationalizing its All Case Rates packages to further improve financial coverage and  lower, if not eradicate the patients out-of 

pocket expenses.  

Ledesma explained that “PhilHealth is  continuously improving its benefit  packages in line with our thrust Pinalawak at mga Bagong Benepisyo para sa  Mamamayang Filipino. We are hoping  that these enhancements bring positive  impact in the behavior of the Filipinos in  seeking medical attention. Sa mga nangangailangang magpagamot, huwag  na pong magdalawang isip dahil  nakaalalay ang PhilHealth sa kanilang  gastusing medikal”. 

PhilHealth also reminded the members  that the adjusted case rates may be availed  of in Levels 1 to 3 accredited public and private health facilities nationwide.  Meanwhile, the previous rates of P11,700  for neonatal sepsis and P9,000 for  bronchial asthma will be applied to patients  admitted in accredited primary care  facilities. 

The state agency also emphasized the  important role that primary care plays in  disease prevention and early detection. It  has again called on primary care facilities to  be Konsulta Package Providers (KPP) to  provide wider access to drugs and  medicines for the control of asthma. “Since  our accredited KPP provides  consultations, drugs and medicines and  laboratory tests, hospital admission due to  worsening of asthma will be avoided”, Ledesma added.  

The PhilHealth Chief also urged all  members to register to their preferred to  Konsulta Package Provider to avail  themselves of free consultations, health  screening and assessment, as well as any of  the 21 essential drugs and medicines and 13  laboratory tests as will be required by their  primary care physician.

PhilHealth, MMDA strengthen joint public info drive

by Info @Brand Zone | April 15, 2023

PhilHealth Photo Release No. 2024-0003 April 15, 2024

PhilHealth President and CEO Emmanuel R. Ledesma, Jr. signed today a Memorandum of Agreement with Metropolitan Manila Development Authority (MMDA) led by Acting Chairman Atty. Romando S. Artes that aims to promote and enhance public awareness on PhilHealth benefits and services through MMDA's digital and non-digital media platforms prominently located throughout Metro Manila. 

The partnership, which is already on its 5th year, will benefit millions of commuters and motorists plying major thoroughfares in the National Capital Region.

"Through our renewed alliance, we aim to enhance access to quality healthcare services for all, especially in the dynamic landscape of the National Capital Region. By synergizing our efforts, we can better address our communities' evolving healthcare needs and contribute to our nation's overall health and resilience,” Ledesma said in his speech.

For his part, Acting Chairman Artes expressed his continuing support to the state health insurer, saying, “Matagal na po tayong nakikipagtulungan sa PhilHealth at asahan po ninyo na patuloy kaming susuporta sa napakagandang programa ng PhilHealth lalong-lalo na sa information dissemination, dahil sa totoo lang napakarami pong magandang proyekto at benepisyo ang binibigay ng PhilHealth.”

Earlier, PhilHealth NCR Office led by Dr. Bernadette Lico announced during the MMDA flag raising ceremony the accreditation of the MMDA Clinic as the country's first non-hospital-based, non-LGU and non-uniformed Konsulta Package Provider that will cater to the Agency’s close to 8,000 traffic enforcers, street sweepers and office-based personnel.

“We would like to give due recognition to MMDA for committing to provide all its dedicated personnel, including their dependents, with the primary care benefit package, such as health profiling, consultations, diagnostic and laboratory tests such as chest X-ray, fasting blood sugar, and electrocardiogram, as well as drugs and medicines for certain medical conditions like asthma, diabetes, and hypertension,” the PhilHealth Chief added.

In photo are (L-R) MMDA Health, Public Safety and Environment Protection Office Director and Officer-in-Charge for Office of the Assistant General Manager for Planning Atty. Victor Pablo Trinidad, Assistant General Manager for Operations Asec. David Angelo Vargas, Deputy Chairman Usec. Frisco San Juan, Jr., Acting Chairman Artes, PhilHealth PCEO Ledesma, Acting Vice President for Corporate Affairs Rey Baleña, and NCR Vice President Dr. Bernadette Lico during the signing ceremony at MMDA’s head office in Pasig City on April 15, 2024.