Center for Health Market Innovations (CHMI)

Programs

PhilHealth KaSAPI (Kalusugang Sigurado at Abot-Kaya sa PhilHealth Insurance)

last updated May 30, 2012

Overview

Implementing organization: 
Philippine Health Insurance Corporation (PhilHealth)
Legal Status: 
Public-private partnership
Year Launched: 
2005
Stage: 
Existing/expansion stage
Income Level of Target Population: 
20-60% (lower to lower-middle)

Funding

Primary Source of Funding: 
Government

Scale

Number of Clients Served: 
28,000 (2009)
Upscaling: 
Based on PhilHealth data, the number of KASAPI members increased from 1,900 to almost 28,000 in 2009.
Summary: 

KaSAPI is a program developed to provide social health insurance through partnerships with organized groups (OG) for members in the informal sector. It specifically aims to provide access to quality health care services to a wider membership base and sustain membership of the OG members.

Program goals/rationale: 

The National Health Insurance Program (NHIP) aims to provide health care access to all segments of society. However, a study has shown that only 40 percent of the total population is covered. In a country wherein significant portion of its labor force is in the informal sector, it is deemed necessary to have systematic mechanism to include them in the safety net loop. In 2005, PhilHealth launched its KaSAPI (Kalusugang Sigurado at Abot-Kaya sa PhilHealth Insurance) initiative, a program to enhance enrolment among informal economy employees.

Key program components: 

Under KaSAPI, PhilHealth enters into strategic partnerships with institutions such as cooperatives, NGOs and rural banks, many of which specifically serve informal economy employees. The strategy thus portrays a good example of good partnership between government and non-government sectors.

The KaSAPI program is supposed to be a triple-win for the three actors in the program: (1) informal economy workers receive protection when they fall ill, payment for them is more flexible (saving them time and effort), they have lower premium and more benefits; (2) PhilHealth benefits from increased, sustained coverage and improved financial stability of the program for informal sector workers; and (3) the partner institution is able to fulfill its social mission, gain additional membership, and reduce risk.

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