- - - - -Financial coverage – this is the assurance that medicines and other fees will be affordable and that the poor and indigent will be able to access these services at low or even without cost. All benefit payments will go to a special health fund which shall be managed (pending in IRR) either by the province or the city. It is supposed to be outside of the general fund of the LGUs. It is placed outside the GAA funds so that it will be easier accessed for health services. All these network delivery services have always been in PhilHealth, it was used to be called Inter-local Health District Zone for the sole purpose of referral, with the primary care deliverers acting as a gatekeeper. But it could be that it takes a law for these to be properly implemented. The law also streamlines the partnership between the agencies, (i.e. DOH, CHED, DepEd – pertaining to health promotions) as well as private health institutions. There will be public hearings and FGD on whether private institutions would be willing to join the health service delivery network due to issues that some doctors fail to get their professional fees from the LGU, which is wrong since there are provisions of incentives for health professionals. There will be a price index for medicines that can be subsidized by the UHCL and it will be available to view for all. c. How will PhilHealth ensure that the UHCL will reach the GIDA and other far-flung areas. - The POS is supposed to be the catch-all-basin for the UHCL. If they are not caught within the other programs (NHTS, Expanded Senior Citizen, PWDs etc.) this is supposed to act as the safety net to ensure that coverage will reach everybody. - PhilHealth really needs the help of NCIP with regards to the records for indigenous peoples in order to ensure effective coverage - The agency also has promotions for informal sector, particularly highlighting the 6.60 PHP needed daily for PhilHealth coverage including your dependents. Their regional offices go around neighborhoods and tap specific groups like tricycle drivers, women groups, and involve non-government organizations, civic organizations, micro-finance institutions and the like. 3. What are the Key Performance Indicators for the agency? - Coverage, benefit payments, percentage of support value (the percentage of the actual value paid by PhilHealth based on the hospital bill) she adds that it is the obligation of the hospitals to tell the patient how much is the benefit package offered by PhilHealth and what relative services can be covered by the package based on the type of case. (Case rate – they used to have a per service fee, but they changed it on a per case basis and there is a corresponding rate relative to the type of case/sickness i.e. the Pneumonia case rate is 16,000 PHP which covers everything from hospital fee, professional fees, room rates etc.) - Under the UHCL, all the relevant data pertaining to benefit payments and support value should be rigorously provided by the hospital for checking. This will ensure that the agency is paying correct amounts and dubious practices by some hospitals will be prevented. 61