Module 5, Session 1

2 4

LGU Collaboration LGU Collaboration and -

Objectives of the Session Definition of NHIP Principles Guiding of NHIP Importance NHIP of Partnership Source as of Funds Inter Partnership in achieving Universal Coverage Benefits of NHIP The Gains and Benefits on adopting NHIP: the The Experience • • • • • • • •

and and budget. Learn from the experiences of other ILHZs. Appreciate the results brought about by the collaboration between PhilHealth and the ILHZs. through through its integration in their plans Outline • •

3 1

Understand Understand the significance the of NHIP in the region. Understand and familiarize themselves on the important role of the ILHZ in the PhilHealth coverage of the people. Ensure sustainability of the PhilHealth coverage of their constituents. Take active an role in the PhilHealth the implementation of programs in their respective areas OBJECTIVES SESSION OF THE OBJECTIVES • • • •

1 Module 5, Session 1

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he country’s largest social largest country’s he

aims for universal coverage for universal aims and comprehensive ensures care medical responsive members program for benefits and beneficiaries

T that…. insurance health

Sharing

– Equity Devolution Fiduciary Responsibility Informed Choice Maximum Community Participation Cost Quality Services of Responsiveness Innovation Cost Containment What What is NHIP? • • • • • • • • • •

7 5

(NHIP)”

NATIONAL HEALTH NATIONAL

“AN OVERVIEW OF THE OF OVERVIEW “AN INSURANCE PROGRAM INSURANCE Allocation Allocation of National Resources for Health Universality Compulsary Coverage Professional Responsibility of Health Care Providers Public Health Services Care for the Indigent Social Solidarity Effectiveness GUIDING PRINCIPLES OF THE NHIP THE OF PRINCIPLES GUIDING • • • • • • • •

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(as source of source funds) (as

related programs programs related

– PROVINCIAL MUNICIPAL CONGRESSIONAL/ 1. 2. PROVINCIAL/ 3. MUNICIPAL/

Provides Provides a challenge to health care providers to improve their skills and facilities Provides an opportunity for collaboration and cooperation between and among agencies government the for a Provides chance and private sectors not only forge to new partnerships also but renew to and strengthen existing ones Provides additional source of funds for health and health and activities of the LGUs • • • • SP PARTNERSHIPS PARTNERSHIPS SP

9

11

hearted hearted -

CAR) Poolingoffunds

The rich subsidizes the poor richsubsidizesThe sickthe subsidizeshealthy The oldthe subsidizesyoung The the subsidizesemployed The unemployed • • • • IMPORTANCE OF THE NHIP (IN NHIP THE OF IMPORTANCE their their services other to ventures Provides an opportunity big to individuals to share their blessings by enrolling the less fortunate and economically challenged members of the community to PhilHealth Provides Provides a venue for LGUs to provide social insurance coverage the to people Gives an opportunity for people’s organization (cooperatives, farmers and women’s groups, etc.) expand to

• • • Social Solidarity thru PhilHeath thru Solidarity Social

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THE

COVERAGE BENGUET BENGUET LGU COLLABORATION ANDCOLLABORATION LGU EXPERIENCE - 50% 50% SHARING SCHEME 50% SHARING SCHEME

- - INTER PARTNERSHIP IN ACHIEVING INPARTNERSHIP UNIVERSAL 50% 50% BETWEEN THE PROVINCE AND ITS COMPONENT MUNICIPALITIES 50% BETWEEN THE OFFICE OF THE CONGRESSMAN AND THE PROVINCIAL GOVERNMENT KABAYAN MUNICIPALITY ALLOCATING P10,000.00/BRGY FOR THEIR SPONSORSHIP • • •

15 13

PFPR AMOUNT PFPR 8,290,500.00 P14,789,500

PCB1 500/FAMILY 500/FAMILY

# OF# ENROLLEES 29,579 16,581 ORGANIZATIONS PRIVATE INDIVIDUALS MUNICIPALITIES BARANGAYS ILHZ PEOPLE’S

OTHER SPONSORS OTHER

(PROJECTED PCB FOR 2012) FOR PCB (PROJECTED • • • • •

BENEFITS FROM PHILHEALTH PHILHEALTH FROM BENEFITS PROVINCE

4 Module 5, Session 1

18 20

13,270

6,421 12,895 IN THE IN PROGRAM PROGRAM AS OF DECEMBER, 2011 DECEMBER, OF AS PROVINCE 6,692 THE SPONSORED SPONSORED THE 0 SP ENROLLMENT ILHZ SP ENROLLMENT PER 8,000 6,000 4,000 2,000 14,000 12,000 10,000

19 17 1,735 7,955 101

4,606 4,478 1,864 (JULY, (JULY, 2011) 12,796 3,247 - 8,000 6,000 4,000 2,000 SPONSORED PROGRAM ENROLLMENT 14,000 12,000 10,000

5 Module 5, Session 1

22 24 17,755

29,579

SPONSORED MT. PROV MT.

31,062

1,795

KALINGA LIFETIME

16,538 IPP 10,250 31,288

8,905 BENGUET OFW

4,791 BGO CITY BGO 7,793 PRIV (AS OF MAY 31, 2012) 31, OF MAY (AS 16,581

ABRA (AS OF MAY 31, 2012) 31, (AS OF MAYABRA APAYAO 8,432

GOVT STATUS OF SP ENROLLMENT IN CAR ENROLLMENT OF SP STATUS 29,579 ABRA 0 0 STATUS OF MEMBERSHIP REGISTRATION IN REGISTRATION MEMBERSHIP OF STATUS 5,000 30,000 25,000 20,000 15,000 10,000 5,000 15,000 10,000 35,000 30,000 25,000 20,000

23 21

16,581 SPONSORED

10,022 MT. TRAIL MT. 286 LIFETIME

3K 4,563 IPP 2,733

2,967 OFW 7,639 BLISSTT 1,786 AS OF MAY, 2012 MAY, AS OF PRIV

BKD 5,890 APAYAO (AS OF MAY 31, 2012) 31, OF MAY(AS APAYAO 3,910 GOVT 0 0 4,000 2,000 8,000 6,000 8,000 6,000 4,000 2,000 STATUS OF MEMBERSHIP REGISTRATION IN REGISTRATION MEMBERSHIP OF STATUS SP ENROLLMENT SP ENROLLMENT PER ILHZ 18,000 16,000 14,000 12,000 10,000 12,000 10,000

6 Module 5, Session 1

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AMOUNT 2011 P70,403.14 -

17 PAID NO. OF NO. OF CLAIMS

P12,240.00 PREMIUM PAID

71 30 - 3K 3K ILHZ BENEFIT - NO. OF NO. OF MATERNITY ENROLLEES AVAILMENT FOR 2010 CARE PACKAGE CARE

27 25

5,936,648.76 2,715,748.53 6,471,804.81 4,570,407.12 19,694,609.22

BENEFIT AMOUNT BENEFIT

896 475 731 689 2,791 NO. OF NO.

CLAIMS

3,005 4,820 2,827 3,273 13,925 NO. OF NO. ENROLLEES

(2011) 562,117.50 368,775.00 790,275.00 BENEFIT BENEFIT 1,019,117.50 2,741,017.50 3,242,910.00 5,983,927.50 PREMIUM PAID PREMIUM AVAILMENT

TOTAL ILHZ

PROVINCIAL/MUNICIPAL PROVINCIAL/MUNICIPAL SP

PROVL SHARE PROVL BLIISTT 3K TRAIL MT. BKD

7 Module 5, Session 1

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4,500.00 4,500.00 TOTAL

TOTAL 4,500.00 2008 3K ILHZ 3K

TBDOTS PACKAGE TBDOTS MUNICIPALITY KAPANGAN KIBUNGAN

31 29 23,150.00 TOTAL 178,190.00 1,354,190.00 1,152,850.00 5,000.00 11,500.00 TOTAL 6,500.00

2011 19,500.00 855,350.00 TOTAL 4,000.00 2011 4,000.00

2010 3,650.00 233,650.00 2010 2,500.00 2,500.00

2009 22,750.00 54,850.00 2009 2,500.00 2,500.00

BKD ILHZ BKD 2008 2008 18,850.00 9,000.00

MT. TRAIL ILHZ TRAIL MT.

2007 2007 2,500.00 136,590.00

MUN BOKOD KABAYAN TOTAL MUN BAKUN ATOK

8 Module 5, Session 1

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63,055.44 29,299.73 2011 437,932.54 101,442.86 434,370.33 489,104.21 261,862.50 209,437.12 402,285.42 162,621.58 333,809.17 223,374.46 538,048.33 3,686,643.69 TOTAL

19,500.00 19,500.00

2010 352,118.73 458,625.00 206,402.47 487,875.00 282,557.61 453,862.50 288,125.32 995,601.96 642,043.26 405,983.33 194,400.00 269,475.00 405,088.04

5,442,158.04

- -

2011 9,000.00 2009 71,179.94 54,893.41 82,126.96 89,625.00 44,228.01 115,732.08 117,450.00 329,625.00 104,325.00 424,726.65 265,650.00 TOTAL

1,699,332.97

30,000.00 91,200.00 2008 119,002.99 511,312.09 218,836.75 177,501.10 218,434.42 497,630.71 166,644.23 469,405.21 237,531.60 203,546.71 500,325.00 2010 3,441,370.81 8,000.00

4,500.00 64,392.95 12,225.00 15,458.98 30,000.00 45,600.00 2007 431,373.81 149,878.02 858,726.92 149,222.28 379,654.17 146,993.33 294,969.23 2,582,994.69

- - BLIISTT LIHZ BLIISTT 2009

2,500.00 9,956.04 21,586.14 25,597.83 28,416.66 45,600.00 2006 973,311.26 130,304.00 130,551.24 165,476.37 136,638.59 592,407.70

2,259,845.83

ANNUAL PCF RELEASES PER MUNICIPALITY PER PCF RELEASES ANNUAL

TOTAL MUN MUNICIPALITY KIBUNGAN TRINIDAD LA MANKAYAN SABLAN TUBA ATOK BAKUN BOKOD BUGUIAS KABAYAN KAPANGAN ITOGON TRIN. LA SABLAN TUBA TUBLAY

35 33 72,500.00 178,190.00 250,690.00 TOTAL

TOTAL

18,500.00 2011

9,000.00 2010

22,750.00 34,500.00 2009

2011 18,850.00 2008

8,000.00 136,590.00 2007

MT. TRAIL ILHZ TRAIL MT. 2,500.00 2006

TBDOTS ACCREDITED FOR

ALL RHUs ALL RHUs IN BENGUET ARE

ATOK BAKUN BUGUIAS MANKAYAN MUN

9 Module 5, Session 1

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6,043,389.67 32,542,774.62 38,557,739.64 77,143,903.93

2011) - (2006

PATIENT PATIENT HOSPITALS TO PAID BENEFITS - TOTAL IN 3K ILHZ enrolled 101 families under under families 101 enrolled ILHZ 3K Program Sponsoredthe Program Sponsored the of Integration (CHTF) budget and plans their to where summit a health of conduct The an to give was invited PhilHealth NHIP on the orientation PROGRAMS/ACTIVITIES PROGRAMS/ACTIVITIES INITIATED BY LEPANTO CONSOLIDATED MINING CONSOLIDATED LEPANTO HOSPITAL CORPORATION MISSION MEDICAL LUTHERAN REHABILITATION AND INC. FOUNDATION, PHILEX OF HOSPITAL NINO STO. CORPORATION MINING THE ILHZs IN SUPPORT TO PHILHEALTH • • • PRIVATE HOSPITALS PRIVATE

39 37

4,024,654.55 1,163,803.30 4,612,644.19 12,287,812.02 10,994,804.05 196,983,017.98 230,066,741.09

2011)

-

(2006

LGUs

PATIENT PATIENT HOSPITALS TO PAID BENEFITS - TOTAL IN

REPAIR RHUs OF REPAIR and DRUGS OF PURCHASE MEDICINES TRAININGS CAPABILITY AND EQUIPMENT OF PURCHASE RHUs FOR SUPPLIES OFFICE PCF PCF UTILIZATION BY THE COMMUNITY HOSPITAL COMMUNITY BENGUET GENERAL HOSPITAL GENERAL BENGUET MEMORIAL MOLINTAS DENNIS HOSPITAL HOSPITAL MUNICIPAL ITOGON MEDICARE KAPANGAN ABATAN EMERGENCY HOSPITAL EMERGENCY ABATAN HOSPITAL DISTRICT ATOK • • • • LGU OWNED HOSPITALS OWNED LGU

10 Module 5, Session 1

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IN) - 2013

– FOR FOR THE (LOCK 2012 MOA MOA SIGNING Encouragement of the owners of small small of owners the of Encouragement as Individually enroll to businesses members (IPM) Program Paying the to aide funds of Allocation of payment the in families indigent bills hospital their to facilities and manpowerof Sharing acrreditation PhilHealth track fast SPONSORED SPONSORED PROGRAM FOR • • •

43 41

DOs OF THE SPONSORED SPONSORED THE OF DOs PROGRAM IMPLEMENTATION PROGRAM Intensive Intensive orientation the NHIPon (Mobilize and strengthen the community) Active of support the LGUs Preparation and submission of reports required by PhilHealth Timely payment premiums of Increase enrolment Accreditation of health care providers (both personnel and facility) Crafting of a resolution requesting the the requesting a resolution of Crafting to owners business to require MLGUs as to PhilHealth employees their enroll of renewal and issuance the of part permits business their BLIISTT ILHZ forwarded a resolution a resolution forwarded ILHZ BLIISTT Cosalan Congressman of office the to the of renewal the for sponsorship Congressional/Provincial actively Officials Barangay and LCES IECs of conduct the in participate • • • • • • • • •

11 Module 5, Session 1

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THE MUNICIPALITY OF BUGUIAS AND ITS BARANGAYS ITS AND BUGUIAS OF MUNICIPALITY THE MOA SIGNING WITH VARIOUS PARTNERS VARIOUS WITH SIGNING MOA

47 45

MUNICIPALITIES MOA SIGNING WITH THE PROVINCIAL GOVT AND ITS COMPONENT COMPONENT ITS AND GOVT PROVINCIAL THE WITH SIGNING MOA

12 Module 5, Session 1

50

51 49

 TAYO AMIN AMIN TAYO COMMUNITY ORGANIZING TRAINING FOR MUNICIPAL MUNICIPAL FOR TRAINING ORGANIZING COMMUNITY AND BARANGAY OFFICIALS, MSWDO STAFF AND BHWs AND STAFF MSWDO OFFICIALS, BARANGAY AND NARAGSAK NGA ALDAW ALDAW NGA NARAGSAK

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