ABSTRACT
The descriptive study was conducted to describe the policy mandate of Philippine Health Insurance Corporation (Philhealth) and its implementing mechanisms; determine the program outcomes in terms of awareness, participation, and appreciation; identify the problems encountered in implementation; and give possible recommendations to improve the program. A researcher-made questionnaire was developed, validated, and pilot-tested for reliability. Respondents were fifty PhilHealth members from the different areas in Iloilo. Statistical tools used were frequency count, percentage, mean, and standard deviation. Results of the study revealed that respondents were very satisfied of PhilHealth programs, and benefits in terms of awareness, participation, and appreciation. Problems or issues encountered by majority of recipients were the orientation and updating of membership data, regular payment of premium contributions, and registration with nearest primary care provider. Recommendations were formulated to improve the PhilHealth programs and benefits.
Keywords: Policy Mandate, Implementation, PhilHealth Program
INTRODUCTION
Health outcomes in the Philippines have improved over the years. This is because of the improved access to health and the health seeking behavior of the people.
However, it still faces new challenges over the years that greatly affect the health of the people. This is brought about by inequities, out-of-pocket expenses, and lack of knowledge towards health.
Those living in the far flung areas with low socio-economic status, and lower educational background are severely affected and suffer financial burden from overspending for health. This is true in cases of terminal and catastrophic illness where out-of-pocket is a problem and is still increasing in all income groups.
PhilHealth, as the administrator of National Health Insurance Program (NHIP), was established in 1995 through the Republic Act (RA) 7875 (Revised IRR National Health Insurance Act, 2013). It is mandated to provide social health insurance coverage to all Filipinos.
With its continuous commitment to become responsive to the needs of its members, PhilHealth has improved the delivery of health services, from primary health care to improved hospital care, and coverage of catastrophic conditions.
On February 2019, the years of reform toward achieving the Universal Health Care (UHC) has culminated with the enactment of Republic Act (RA) 11223. The act ensures that all Filipinos are health literate and it provides access to quality and responsive health services.
Four years have passed since its implementation and yet, many remain misinformed of the health benefits and how to access the privileges as provided by the law. This kind of apprehension creates poor outcome toward health information, and healthy behaviors.
To attain a significant level of health literacy, improved health information is necessary through accurate and accessible information dissemination.
The study aimed to evaluate the level of awareness, and the satisfaction of members on PhilHealth programs.
Since the implementation of the Universal Health Care Act in 2019, it is, therefore, desirable to know how far its implementation has reached with regard to the PhilHealth programs and benefits, coverage, and member awareness.
The study aimed to improve the services and programs of PhilHealth by strengthening awareness through effective information dissemination activities, address relevant issues or concerns, and enhance policy program implementations.
Further, the study was conducted to provide data as reference of people or organizations that could be used in special areas of concern by the following people or organizations:
PhilHealth. The result of the study would be of great help to the corporation in assessing its programs and benefits, coverage, and member awareness.
PhilHealth Members. The study would help members to be more familiar with the programs and activities which further increase their level of awareness, and serve as baseline study on the level of client satisfaction, and financial risk protection program offered by corporation.
Health Care Providers. Health Care Providers would be more informed of the PhilHealth programs, and be aware of the effects to the members as well as deliver maximum benefits, and render quality services to the members and their dependents, respectively.
Health Care Institutions. The study would help Health Care Institutions to be aware of its effect on the beneficiaries, and be motivated to contract to the programs of PhilHealth for the betterment of the members and their dependents. be more updated of the programs of the corporation,
Local Government Units. The study would help Local Government Units (LGUs)in the registration of their constituents with the program, especially those who do not have the capacity to pay and further assist them on the awareness of the people on the policies and benefits of PhilHealth.
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