PhilHealth’s Konsulta implementation strengthened

The Philippine Health Insurance Corp. (PhilHealth) is expanding its Konsultasyong Sulit at Tama (Konsulta) program as part of its commitment to achieving universal health care (UHC) in the Philippines.

Since the enactment of the Universal Health Care Act in 2019, the country has made significant strides toward providing accessible and affordable health care services. PhilHealth's outpatient package has been a key component of these efforts.

However, much work remains to be done to fully realize UHC, as PhilHealth announced Thursday that it is necessary to expand the network of accredited Konsulta service providers and improve communication efforts to ensure that providers and beneficiaries are fully informed about these vital services.

To address these gaps and support PhilHealth in expanding the implementation of Konsulta, the Unilab Center for Health Policy (UCHP) convened stakeholders from various sectors, including PhilHealth, local government units, private providers, and patient groups, in a roundtable discussion last September.

During the roundtable, UCHP introduced the Konsulta Manual of Operations (MOP), a guidebook designed to streamline the implementation of the Konsulta program for healthcare providers and local government units.

"We all have a unique opportunity to address the challenges of primary health care," said Unilab Foundation executive director Atty. Jose Maria Ochave. "In this roundtable discussion, we can take small, yet deliberate and steady steps that will advance the 'health for all' promise of Universal Health Care."

PhilHealth's Konsulta program aims to promote proactive health care by providing Filipinos with access to a range of services, including consultations, health risk screenings, laboratory tests, and essential medicines.

Launched nationwide in 2020, Konsulta has seen significant growth in the number of accredited providers. However, the country still faces challenges in meeting the ideal ratio of one primary care facility for every 20,000 Filipinos.

To address these challenges, PhilHealth has engaged in open discussions with stakeholders to identify and address the obstacles hindering the implementation of Konsulta. These include difficulties with finances, facility accreditation, patient registration, patient awareness, and information dissemination.

"The Unilab Center for Health Policy believes in PhilHealth's Konsulta," stated UCHP Program Director Ruben Basa. "That's why, when it was launched, one of UCHP's first priority projects was to develop the Manual of Operations for the Konsulta package."

The Manual of Operations provides a comprehensive guide for healthcare providers on key aspects of the Konsulta program, including membership registration, provider accreditation, social mobilization, benefits availment, provider billing, payment processes, and information systems.