Center for Health Market Innovations (CHMI)

Programs

Guimaras Health Insurance Project

last updated Dec 12, 2011

Overview

Implementing organization: 
Guimaras Provincial Government
Legal Status: 
State/government
Year Launched: 
1993
Stage: 
Existing/expansion stage
Income Level of Target Population: 
All income levels

Funding

Primary Source of Funding: 
Government

Scale

Number of Clients Served: 
21,127 active members (2010)
Summary: 

In a country where national social insurance and micro-insurance symbiotically exist, it is rare to observe sustainability of the latter. For almost two decades, the micro-insurance of Guimaras was able to withstand roadblocks in achieving fiscal efficiency and able to deliver financial protection to the majority of the provincial population.

Program goals/rationale: 

Inaccessible, inefficient and inadequate health services are harsh realities that continue to confront our people, particularly the poor segment of the population. Trying different approaches and strategies, the government has come up with the Medicare I Program – a compulsory health insurance scheme which was implemented in 1972 under the Philippine Medical Care Commission (PMCC), now Philippine Health Insurance Corporation (PHIC), popularly known as PhilHealth. Its coverage included the formal salaried-sector and their dependents. The non-formal sector was being left out. To fill in the gap, a parallel program was conceptualized which was called the Medicare II. This program was implemented in pilot provinces to test its viability and one of the chosen sites was the Province of Guimaras, thus the birth of the Guimaras Health Insurance Project (GHIP).

Key program components: 

In 1993, Guimaras Health Insurance Project (GHIP) was established with the aim to provide adequate and accessible health care. GHIP offers inpatient benefits to their members and dependents. The amount of benefit that members can get during admission is dependent the health plan availed and the degree of case (ordinary, intensive and catastrophic).

To support this project, cost-sharing scheme in the payment system for annual contribution of Php 150.00 was established. The 85-65 sharing (85 by the members, 25 by the municipality and 40 by the province) was adopted. This program was able to give the population benefits and security in terms of medical intervention/hospitalization.

Unlike any other micro-insurance, one of the features of GHIP is its sustainability. Due to the presence of organized structure and full-time staff the monitor and regulate the business operations. They have also aggressive house to house campaign to increase membership by giving monetary incentives to marketers for every recruit. Currently, there is also an increase support from LGUs and community leaders by giving subsidies to the poor. GHIP has also tapped multi-stakeholders groups of local Goverment Units, Government Agencies, NGOs and community health workers to conduct information dissemination, recruitment, collection and other related activities.

For technical support, the project established a working relationship with GTZ. Through them, the MIS was installed and upgraded both hardware and software. Data encoding for membership, premium payment and claims are being updated. This project was able to receive technical and equipment assistance from SHINE-GTZ (MIS software, Iomega Zip Driver and disks, 1 UPS) and ICHSP (Laser Printer). Likewise, documentation and other office equipment were procured through the utilization of Galing Pook Awards prize.

As of December 2010, GHIP has a total of 21,127 active members representing 77% of total households and a total of 2,845,409.03 medicare community health fund. This is up from 17,000 active members representing 60% of the total households in 2009.

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GHIP Narrative Highlights.pdf146.18 KB
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