Stats and Charts
PHILIPPINE HEALTH INSURANCE CORPORATION January - December ’08
As of Feb 16, 2009
Membership Pie (Sector Distribution)
PhilHealth’s active membership coverage is estimated at 69 million beneficiaries*. This is about 76% of the 2008 projected population of 90 million Filipinos.
Nonpaying 1% OWP 12% Indigent 24%
76%
Private 34% Gov't 11%
IPP 18%
Note: *As of December 2008
Membership by Sector
• Employed sector comprise almost half of estimated active membership
Sector Government-Employed* Private-Employed* Sponsored Program
(Active)
Member 1.86 6.38 3.26 2.72 0.40 1.84 16.46
Beneficiaries 7.74 23.19 16.49 12.51 0.69 8.06 68.67
Individually-Paying* Non-Paying Program
(registered)
Overseas Workers Program(registered) Total
Note: * Gov’t, Private and IPP members are estimated actively-paying members.
Membership: Indigent Members
As of yearend 2008, there are about 3.3M indigent families enrolled. This is about 16.5M beneficiaries of the Sponsored Program.
6 , 2 5 8 , 15 0 4,946,433
3,263,749 2,492,356 1, 7 6 2 , 116 1, 2 6 0 , 8 6 4 6 19 , 0 14 3 4 7 , 0 16 2,904 47,290 86,827 2 , 7 2 1, 3 8 2
1997
1998
1999
2000
2001 2002
2003
2004
2005 2006
2007
2008
* Actively-Enrolled Members (cumulative figures)
Membership: IPP Members*
By the end of 2008, about 3 million individually-paying members have been enrolled in the program.
2,975,527
2,942,061 2,839,455 2,597,335
2,151,225 1,768,175 1,364,387 929,589 494,462 32,944
1999 2000 2001 2002 2003 2004 2005 2006** 2007 2008
* Registered Members (cumulative figures) ** Decrease due to database clean up/shift to other member category
Membership: Non-Paying Members*
• There are more than 400,000 pensioners & retirees that have been registered as non-paying members.
403,198 336,537
263,456
196,650 135,500
76,209 30,834
2002
2003
2004
2005
2006
2007
2008
* Registered Members (cumulative figures)
Premium Collection
• • • Premium collection have increased steadily over the years from P8.6B in 2000 to P24.7B by the end of 2007. 2007 collections is 7% more than the previous year’s collection. For 2008, premium collection has reached about P25.6B, this is about P1B more than collections of the same period last year.
25.6 24.7 23.1 18.7 17.6 12.7 11.1 8.6 13.2
in billions
2000
2001
2002
2003
2004
2005
2006
2007
2008
Premium Collection by Sector
• • Collection for the indigent sector decreased by 9% compared to the same period of the previous year. IPP members’ collection increased by 20% while collection from government members increased by 14%.
18,000 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 Government Private Indigent OFW IPP
15,439
15,752
* in millions
2007 5,240 4,598 2,982 2,705 630 713 1,231 1,024 2008
Benefit Payments
• • • Benefit payments have substantially increased through the years from payments of P6.8 billion pesos in 2000 to more than P17 billion in 2007. Benefit payment for 2007 is about 2% more than the payment for 2006. As of December 2008, benefit payments increased by more than 4% for the same period of 2007.
17.5
17.4 17.1
18.2
in billions
11.0 6.8 7.7 8.8
12.9
2000
2001
2002
2003
2004
2005
2006
2007
2008
Benefit Payments by Sector
• •
9,000 8,000 7,037 7,000 6,000 5,000 3,644 4,000 3,000 2,000 1,000 Go ve rnm e nt P riva te Indige nt OF W IP P No n-P a ying M e m be r
The nonpaying members had a highest rate of increase in benefit payments at 28% while IPP members payouts increased by 16% Indigent sector benefit payments had the highest rate of decrease of about 14% compared to previous year
7,649
* in millions
2007 2008
3,559 3,087 2,664 2,491 2,148 594 593 936 1,199
Claims Processing
(Benefit Item Distribution)
Room & Prof. Fees 24% Board 17%
•
OR Fee 7% X-Ray/ Lab/ Others 21%
Drugs and medicine comprise about 31% of the total amount paid by PhilHealth while 24% went to professional fees. The trend for the distribution of benefit payment per benefit item has not changed much over the years.
Drugs & Meds 31%
Accreditation
Facilities Hospitals Rural Health Units Free-standing Dialysis Clinics TB-DOTs Centers Maternity Care Clinics Professionals
Number Accredited
1,531 1,217 28 507 396 21,143
Accreditation
(Type of Hospital)
• 9 of 10 DOH-licensed hospitals are accredited by PhilHealth • Private hospitals comprise about 61% of total accredited while the rest are governmentowned.
Private 931 (61%)
Gov't 600 (39%)
Accredited Hospitals per PRO
(as of December 2008)
Type PROs
Private G overnment
Total 139
41 35 63
NCR/Rizal
NCR-Las P iñas NCR-Manila NCR-QC
51
13 16 22
LUZON
CA R I II III IV -A IV -B V
420
16 70 35 96 75 66 62
265
36 37 31 39 37 46 39
190 54 51 85 685 52 107 66 135 112 112 101 232 80 92 60 424 60 106 100 91 47 20 1,531
VISAYAS
VI V II V III
83
22 40 21
149
58 52 39
MINDANAO
IX X XI XII CA RA GA A RMM
289
38 71 83 70 18 9
135
22 35 17 21 29 11
Total
931
600
Accreditation: Out-Patient Facilities
Rural Health Units
PRO NCR-CENTRAL NCR-NORTH NCR-SOUTH CAR I II III IV-A IV-B V VI VII VIII IX X XI XII CARAGA ARMM TOTAL
AntiFree-standing TB/DOTS Dialysis Clinics Clinic
Maternity Clinics
69 30 84 71 90 25 107 40 68 80 114 96 113 44 73 34 27 45 7 1,217
8 4 2 0 2 0 4 1 2 2 0 1 0 0 0 2 0 0 0 28
28 8 22 30 40 6 3 26 7 27 102 47 33 29 43 18 23 13 2 507
34 20 25 6 5 3 41 25 6 12 47 31 28 15 33 41 13 11 0 396
Accredited Collecting Banks/Agencies
Num be r o f Bra n c h e s 3 ,81 4 31 0 24 7 13 9
AC A's Co m m e r c ia l Ba n ks Ag e nc ie s Dir e c tly Ac c r e d ite d Ru r a l Ba n ks No n -Ba n k 28 1 14 2
45 active collecting agencies/banks 4,510 branches nationwide