Center for Health Market Innovations (CHMI)

Programs

Provincial Indigency Health Program: The Bukidnon Model

last updated Sep 17, 2012

Overview

Implementing organization: 
The Provincial Government of Bukidnon
Legal Status: 
State/government
Year Launched: 
2003
Stage: 
Existing/expansion stage
Income Level of Target Population: 
Bottom 20%

Funding

Primary Source of Funding: 
Government

Scale

Number of Clients Served: 
80% of indigent families within the Bukidnon Province
Summary: 

The Provincial Indigency Health Program (PIHP) is a health scheme launched by the Provincial Government of Bukidnon in 2002.

Program goals/rationale: 

Bukidnon is a province located in the Northern Mindanao. A significant portion of the population of the Province of Bukidnon is considered poor, and most of them are located in Indigenous Peoples’ (IP) and farming communities. Because of poverty and the distinct geographical feature of the province made healthcare inaccessible especially for poor communities. This problem was also exacerbated by financial constraints of the provincial government which led to poor hospital infrastructure and paucity of health care professionals. This program has aimed to solve these issues by making the local health financing and service delivery systems more responsive, efficient and sustainable.

Key program components: 

The Bukidnon Model was rolled-out in different phases which involved different strategies and implementation mechanisms.

The first phase involved enrollment of indigents of Bukdnon into the PhilHealth Sponsored Program through premium sharing of the governor and municipal mayors. In 2002, after thorough review and synchronization of the indigents list, they were able to enroll almost 160,000 families in the sponsored program. The Bukidnon Model is the precedent of “no balance billing policy in public hospitals” of the national government. Thus, totally free health care service can be enjoyed by sponsored members. Public hospitals absorb all the balances of the indigent patient (sponsored member) and considered them as non-cash payments. In 2006, PhilHealth Region 10 and Provincial Government of Bukidnon pioneered automation, massive civil registration, database build-up of indigent members and dependents.

Another distinct feature of the Bukidnon Model is institutionalization of Provincial Health Stations (PHS). The Province of Bukidnon constructed 20 PHS scattered across the entire province. PHS serves as a complement to the Rural Health Units specifically for preventive care services. To make the system efficient, rural health units managed by the municipal government covers all public health services such as TB, nutritional advocacies, etc. The existence of the PHS was not intended to compete with the existing RHUs but to support the implementation of the out-patient benefit package of PhilHealth in the province.

Indigents of the province are required to pass by the PHS for the initial consultation and assessment and if admission is needed, shall be referred to the nearest government or private hospital (except for emergency cases).

Program history: 

In the year 2002, when Governor Jose Zubiri III assumed office, he consulted and visited almost 500 barangays and observed the plight of his constituents. During his consultations, a majority of the population demanded a functional and efficient health care system. During the 1990s, though the province had a micro-health insurance which aimed to reduce the out of pocket or hospital bills of the people, the system folded up.

The Province of Bukidnon scanned various options on sustainable and efficient health care system to adopt. That same year, the Bukidon Model which is a scheme to strengthen the enrolment and renewal of indigent members to the PhilHealth Sponsored Program was established. In the succeeding years, the Province also institutionalized many reforms in the health service delivery side by building Provincial Health Stations managed by the provincial government in parallel with Rural Health Units managed by the municipal governments.

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