Center for Health Market Innovations (CHMI)

Programs

PhilHealth Maternity Care Package (MCP)

last updated Sep 27, 2011

Overview

Implementing organization: 
Philippine Health Insurance Corporation (PhilHealth)
Legal Status: 
State/government
Year Launched: 
2003
Stage: 
Existing/expansion stage
Income Level of Target Population: 
All income levels

Funding

Primary Source of Funding: 
Government
Summary: 

Maternal Care Package for normal spontaneous delivery utilizes a case payment scheme in claims reimbursement. This shall be implemented in all PhilHealth-accredited hospitals and accredited non-hospital facilities (Lying-in Clinics) in the country. In 2009, PhilHealth expanded its MCP and will now cover up to the fourth birth.

Program goals/rationale: 

Maternal mortality is still relatively high in the country. According to Philippine MDG watch, MMR is still far from the 2015 target. In response, the Philippine Health Insurance Corporation launched a special package for its members which cover the financial needs during delivery. In addition, the package includes pre and post natal services like antenatal check-up, family planning services and immunization.

Key program components: 

In 2003, the case rate was divided into 2,000 pesos for the health professional and 2,500 for the health facility. The payment for health facility is expected to cover for the necessary room and board, drugs and medicines, diagnostics, operating room and all other medically necessary care except for professional fees. In 2009, the MCP package was increased to 6,500 and can now be used up to the fourth birth. For non-hospital facilities like lying-in clinics, midwife-managed clinics, birthing home and other similar health facilities, they shall be accredited by PhilHealth before they can provide with the package. The payment for the health facility is expected to cover for room and board, medicines, diagnostics and professional fees. In order to ensure holistic quality of health care for both mother and child, case rate payment for non-hospital facilities shall be divided into the ff: (1) Prenatal care and NSD (2) Post natal care and family planning.

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