Submitted by: Hannah Elaine A Ortiz 2017-06-08 00:00:00 Last Updated by: Jeverly Ann S. Principe 2017-06-09 14:39:26 Export to PDF

Assessment of the PhilHealth Accounts Management Strategy (PAMS)

PHRR170609-001558

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Assessment of the PhilHealth Accounts Management Strategy (PAMS)

Health Financing through the Philippine Health Insurance Corporation is one of   the three guarantees of the Philippine Health Agenda of this administration and aims in extending quality, accessible and affordable health services to all Filipinos. PhilHealth as the implementer of the National Health Insurance Program guarantee that benefits are given and utilized by its members thru efficient premium collection system. Efficient premium collection is a vital core function of a social health insurance program to ensure fund sustainability and program viability. In 2012, PhilHealth launched the PhilHealth Accounts Management Strategy (PAMS) as an account management strategy aimed at improving collection efficiency, and the monitoring of the partner employees of the corporation. In order to deliver PAMS, over 225 PhilHealth Accounts Information Specialists (PAIMS) were deployed in 17 PROs as additional human resource complement focusing on the accounts monitoring function. This assessment aims to determine the effectiveness of the system collection under PAMS and suggest further innovations in further developing the system.

Regime Classification Priority
2010 - 2016 Health Financing Financial Risk Protection
Start Date Duration in Months Target Completion Date Actual Completion Date
2017-05-01 5 2017-10-01 0000-00-00

Ongoing

Institution Classification Region LTO #
Health Perspective Inc None NCR
Institution Classification Region LTO #
Philippine Health Insurance Corporation Government NCR
Institution Amount Region
Philippine Health Insurance Corporation N/A NCR
Name Expertise Affiliation
Maria Ofelia O. Alcantara, MD, MPH Health Policy and Health System Health Perspective Inc
Leonardo A. Alcantara, MD, MPH Health Policy and Health System Health Perspective Inc

The main objective of the study is to assess the effectiveness of the PhilHealth Accounts Management Strategy (PAMS) in improving PhilHealth’s collection efficiency and in maintaining employers awareness of the PhilHealth’s programs and policies. Specific Objectives include (1) To determine changes in the collection efficiency in the PROs before and after implementation of PAMS,  measured by (a) Registration, (b) Remittance Rate, (c) Reporting Rate ; (2) To measure the knowledge and awareness of  PhilHealth programs and policies among PhilHealth Employers Engagement Representatives (PEERs); (3) To identify the strength and weakness of the PAMS and; (4) To recommend process improvements and policy changes to effectively scale up the project. 

 

The PAMS assessment shall be able to guide PhilHealth in efficient collection of premiums from partner employees and employers. The study shall also be able to determine gaps and issues that need to be improved through policy support or operational adjustment of the system. Also, efficient premium collection translates to viability of the program and the provision of benefits to PhilHealth members. 

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01 May 2017

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