Public hospital : revenue enhancement project

Two hospitals were chosen as test sites for the 3-month pilot study: Rizal Medical Center (RMC) in Pasig (Metro Manila), representing urban-based tertiary hospitals, and the Ilocos Regional Hospital (IRC) in La Union (Northern Luzon), representing non-Metro Manila/"rurban-based" tertiary hospitals. Both hospitals have dynamic directors who expressed willingness to adopt whatever system modifications were warranted by the project. The first stage of the study -- problem analysis and documentation -- revealed that (1) current price levels do not fully reflect costs; (2) there exist procedural weaknesses in the present revenue systems; and (3) there are patients who can afford to pay but refuse to do so for some reason. The package of recommendations determined as a result of this first phase was presented for approval by the Department of Health (DOH) since several amendments to the hospitals" internal policies and procedures were required; this approval activity became the study"s intermediate phase and established the framework for test implementation. This monograph presents highlights of the final (or test implementation stage). Section I discusses the implementation structure and basic preparatory tasks, briefly describes the key ingredients of the revenue enhancement measures, and, finally, discusses issues and concerns, the impact of test implementation, and replicability. Section II discusses cost price computation, while Section III presents the billing and collection system. Section IV lists the pricing models for hospital procedures and services at the two pilot facilities. The annex contains samples of the pricing models, cost computations, and flow charts for the billing and collection procedures. (Author abstract, modified)