PhilHealth commits P132M to Quezon, citing province as national model for health care

By Rowena T. Cruz PhilHealth turns over over P132 million to the Quezon Provincial Health Board for the Konsulta Sandbox Program, a new paym...

By Rowena T. Cruz

PhilHealth turns over over P132 million to the Quezon Provincial Health Board for the Konsulta Sandbox Program, a new payment model to enhance primary care services. (Quezon PIO)

LUCENA CITY, Quezon - The Philippine Health Insurance Corporation (PhilHealth) has turned over over P132 million to the Quezon Provincial Health Board, a significant investment designed to enhance primary care services. The funding is a key component of the enhanced Konsulta Sandbox Program, a pilot initiative that positions the province as a national model for a new, prospective payment system.

This new financing model aims to provide healthcare networks with upfront funding rather than relying on reimbursements after services are delivered. This approach gives providers a stable source of income, allowing them to invest in better services and facilities. The model is intended to address the persistent issue of delayed payments to providers, which has been a major challenge in the past.



A central change under the program is a substantial increase in the capitation rate per registered beneficiary, which has been raised from P500 to P1,700 for those who have received a "First Patient Encounter" and Konsulta services. This increased payment provides providers with the resources needed to deliver more comprehensive and continuous care, including consultations, health risk screening, laboratory tests, and essential medicines.

Quezon’s provincial government, led by Governor Angelina Tan, confirmed that the funds will bolster the province’s Special Health Fund. The partnership with PhilHealth demonstrates the strong collaboration required to implement the Universal Health Care (UHC) Act, according to PhilHealth's regional leadership. Quezon was notably one of the country's first seven "sandbox" sites and the first local government unit to establish a Konsulta Primary Care Provider Network.

Konsulta Sandbox Program is a framework for testing innovations in healthcare delivery, including the formation of provider networks with established administrative and clinical referral systems. The goal is to improve the utilization and delivery of Konsulta services while ensuring operational and financial sustainability.

The province’s integrated health system, supervised by the Integrated Provincial Health Office (IPHO), is responsible for promoting and protecting the well-being of its residents, known as "Quezonians." The provincial health board, which includes municipal health officers and other stakeholders, has been actively discussing key initiatives, such as establishing clinical laboratories in primary care facilities.

The funding will also support the province's efforts to enhance its health information systems, supply chain management for medicines, and human resources for health. This integrated approach is designed to create a streamlined, patient-centered system where primary care providers act as the initial point of contact and navigator for patients, coordinating referrals to specialists and hospitals when necessary.