Health finance development

The Department of Health (DOH) and the Philippine Medical Care Commission (PMCC) will head implementation of the project, which will have three components: (1) policy reform; (2) implementation of new health care financing mechanisms; and (3) hospital financing reform. The three components will be highly interdependent; for example, the research agenda developed under the policy component will be carried out in large part under the other two components, as will many demonstration activities. Findings from research and demonstration will then be fed back into the policy process. Inputs for each component will be essentially the same: TA, computer hardware and software, training, research, and demonstration projects. The project will develop a research based, public-private interactive policy development process. (1) Activities to support the DOH"s Health Policy Reform Initiative will include development of a policy framework and research agenda; demonstration projects; promulgation of policy reforms; and monitoring of their impacts. User fees, cost containment, health insurance, and public-private cooperation in health care financing will be among the topics examined by this component. (2) The project will support the creation of an independent forum for health policy dialogue with representatives from public and private medical associations, pharmaceutical companies, communities, the DOH, etc. (3) The project will help develop two data bases: a National Health Accounts Database, to track public and private expenditures; and a Health Policy Database. The component to establish new health care financing mechanisms will have two foci. (1) Assistance will be provided to the PMCC, which oversees the national Medicare program, and its subagencies to expand and reform Medicare. PMCC will, inter alia, develop a Medicare management information system; assess administrative procedures, benefits, and coverage; and explore options for linking Medicare with HMO"s or for merging it with other mandated health funds. (2) The project will encourage other health care financing schemes by financing studies and demonstrations of such options as expanding private insurance, employee benefits, and community financing. The hospital reform component will address both macro/sectoral level and micro/institutional issues. Sector-level activities will include: (1) developing innovations in the management and ownership of public hospitals, with the goal of establishing a sound public/private management-ownership mix; (2) improving the policy environment for private hospitals; and (3) upgrading the DOH"s management of its core public hospital system. Institutional-level activities will mainly involve diagnostic studies of management and services at individual hospitals. The DOH will develop a database on hospital services and costs.