Benefit Payment Table 3: Summary of Claims Paid by PhilHealth, 2018 and 2019 Claims paid by PhilHealth for RPRH-related services, namely, family planning, maternal, infant and child health, treatment of STD and HIV/AIDS infections, treatment of female breast and genital conditions, and men’s health (male genital tract, and z-benefits11 for prostate cancer) decreased by 8.6 percent from 2018 to 2019. Specifically, claims in 2018 totaled to around Php 20.64 billion, while claims in 2019 was pegged at Php 18.86 billion. The data should be interpreted with caution as 2019 figures may still be incomplete as some claims may still be in process at the time of data extraction. For maternal, infant and child health benefits, an eight percent decrease in the payment of claims from Php18.23 billion in 2018 to Php16.73 billion in 2019 was observed. In particular, claims payment for family planning services, namely BTL, IUD insertion, implant, and vasectomy decreased by 21 percent in 2019 [Table 3]. While there was a decrease on the claims paid for various MNCHN benefits, benefit payments for the Newborn Care Package (NCP) increased. In total, PhilHealth paid Php 2.48 billion for NCP in 2019 compared to Php 1.74 billion in 2018. The increase can be attributed to the increase in the package amount for NCP from Php 1,750 to Php 2,950. Overall, reimbursements for RH services have decreased, except for STI and HIV/AIDS benefit packages, which increased by 16 percent from the previous year’s report. In fact PhilHealth reimbursements for RH services has been on a gradual decline in the last couple of years [Figure 6]. Some of the reasons for the decline are: 1) timing in getting the data from PhilHealth database, with some claims in 2019 still being processed; 2) data cleaning made for duplicate computed claims especially for second case rates (ex. deliveries and IUD and IUD claims only); 3) reduced implant claims due to lack of commodities in the facilities. 11 These benefits focus on providing relevant financial risk protection against illnesses perceived as medically and economically catastrophic especially affecting Filipinos belonging to the marginalized sectors of society (PhilHealth Circular 2015-035, Guiding Principles of the Z Benefits) Benefit Package Amount Paid (Pesos) 2018 2019 Family Planning Bilateral Tubal 260,992,000 204,968,000 Ligation IUD insertion 64,680,000 49,734,000 Subdermal Implant 54,843,000 45,420,000 Vasectomy 228,000 116,000 Maternal, Infant and Child Health Deliveries 12,074,886,770 10,993,136,880 Antenatal Care and 556,826,190 467,815,550 Pregnancy Related Conditions Conditions and 677,663,740 565,185,660 Procedures for Post Abortion Care Newborn Care 1,741,019,800 2,380,044,250 Package Perinatal Conditions 3,177,920,780 2,322,936,550 Treatment of STD and HIV/AIDS Infections STD and HIV AIDS 13,447,600 8,889,300 infection OHAT Package 476,610,000 558,472,500 Treatment of Female Breast and Genital Conditions Conditions of the 1,373,977,564 1,091,616,148 breast and female genital tract Benefits for Breast 37,275,000 Cancer Benefits for Cervical 2,575,000 Cancer Men’s Health Conditions of the 171,782,340 132,141,850 male genital tract Benefit for Prostate 400,000 Cancer TOTAL 20,644,877,784 18,860,726,688 Source: PhilHealth Case Rates from 2019 Foregone Reimbursement on FP About 19,000 women benefited from PhilHealth FP benefits packages in 2019, amounting to about Php 300.24 million claims paid. Significant reimbursements were observed in implant services, showing 83 percent of the total reimbursements, followed by IUD (15%) and BTL (2%). 34 2019 Annual Report Responsible Parenthood and Reproductive Health Act of 2012