LINGAYEN, Pangasinan - An executive of the Philippine Health Insurance Corporation (PhilHealth) commended the Capitol’s GUICONSULTA (Government Unified Incentives for Medical Consultations) and urged other provinces to emulate it.
PhilHealth Vice President for Region 1 Dennis B. Adre said in an
interview recently that GUICONSULTA is a commendable program that other
provinces should replicate and make it as a model project.
“We have been coordinating with our head
office to study and evaluate the Pangasinan Business Model and probably adopt
and turn it into a policy,”
Adre said.
Adre said that Philhealth has been trying to influence policy with actual
good practice.
“What we see in Pangasinan, we hope, will be replicated by all the other provinces,” he said adding that Pangasinan is the first to provide counterpart services.
The GUICONSULTA, an exemplary brainchild of Gov. Ramon V. Guico III, was
launched in 2024 and aimed to initially enroll at least two milion
Pangasinenses.
“The intention is to seek out the 3.2 million
population of Pangasinan, get them enrolled into Konsulta and get them to avail
of the free services of PhilHealth-accredited facilities, “ Adre stated.
He added that the province’s GUICONSULTA is indeed a welcome development
for PhilHealth as it complements the latter’s program by helping them promote
the availment of actual services by the members.
Konsulta is an outpatient program of the PhilHealth which started in
2020.
“In Pangasinan, we have started negotiating
with the province to engage as a whole provincial health network. But we
started out by accrediting individual rural health units of the 48
municipalities. Now, they’re organized as one provincial health network,” he said.
Moreover, Adre said that the capitation worth P1,700 is being paid to the
partner accredited facilities to include the 14 hospitals operated by the
provincial government for actual services or outpatient services rendered.
The Philhealth VP said the P1,700 capitation goes to the member’s
laboratory fees. It is also used for maintenance medicines of the member to
include antibiotics, anti-diabetes, and hypertension medicines which is in
contrary to what detractors claimed about reimbursements
“In the case of Pangasinan, they have come up with an 80-20 sharing scheme which
is provided for in a memorandum of agreement signed by and among the 48
municipalities and cities,” he said.
He added that 80 percent is being held in trust by the province in a special health fund as contained in a resolution. On the other hand, the 20 percent goes directly to the LGUs.
In lauding the scheme, Adre said: “What’s
striking about the plans of what we call the Pangasinan Business Model is the
intention to invest in infrastructure among others.
They intend to invest it into an Apex
Hospital. And they intend to upgrade the existing facilities the province to
meet the needs of all our members.”
As to the P300 being given by the provincial government to enrollees,
Adre said it did not come from PhilHealth but from the coffers of the province.
“As of now PhilHealth has not been able to
pay for that purpose. Our engagement with them as one whole provincial health
network, we have not been able to give even a peso,” he stated.
GUICONSULTA was launched by the province as a counterpart service to
Philhealth’s Konsulta program.
Expensive diagnostic procedures like mammogram, for example, is included
in the free services along with other laboratory services.
(Ruby F. Rayat/PIMRO)
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