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Novartis & AWH eye healthcare financing for rural areas

(Source: Businessmirror.com.ph)

SINGAPORE—Global private health-care firms are looking to establish community-based insurance in the Philippines, in an effort to extend health-care financing to the low-income rural population of the country.

Novartis Social Business (NSB), in partnership with Allied World Healthcare (AWH), said they are eyeing to create an integrated finance model, one which can be used alongside the existing government-finance health-care coverage—or the Philippine Health Insurance Corp. (PhilHealth).

The discussion on their partnership for a complementary healthcare insurance establishment in the Philippines is part of the fourth Novartis Social Business Stakeholders Dialogue, with this year’s theme being “Innovative solutions to bridge unmet health needs in Asia.”

“We have been partnering with Allied World Healthcare in the Philippines to see how we can use technology so that we can inform ourselves about the need of these more remote communities because the Philippines has some very distinct challenges because of your geography and the number of islands,” Novartis Social Business Asia Head Deborah Gildea said. Gildea was also a panelist at the stakeholders dialogue.

“What we have learned over the last years in terms of the physical barriers for patients and what we are now looking to see is that there is a way to complement the PhilHealth program—which we know has already started to make good progress in terms of improved access to health care for patients. We also know the size of the task is enormous and there is a way that patients might be able to buy a community-based insurance that would then help complement the gaps within current primary public health-care system,” she said in an interview with Filipino reporters at the sidelines of the NSB Stakeholders Dialogue.

More specific details of the community-based health-care coverage are still on the works, but Allied World Healthcare CEO Edward Booty said the framework is seen to be a top-up insurance policy that will be backed by private, community-led, group health insurance policies based on wholesale-priced pharmaceutical products.

A top-up insurance coverage is a healthcare plan that is usually designed to complement a preexistingly owned medical coverage by covering healthcare costs after a certain threshold amount.

In particular, while a traditional insurance coverage such as PhilHealth will pay up to a set amount based on your insured limit, a top-up insurance will pay for the claim over and above a certain limit that is usually beyond the limit of one’s existing cover.

“In insurance, to top-up PhilHealth for rural patients; what we are really trying to do is work with the public sector and work with the municipalities, work with the government to understand what the patients cannot afford and cannot access,” Booty said.

The NSB and Allied World Healthcare partnership also established other projects in the Philippines to help far-flung patients to access reasonable medical resources related to healthcare services such as data collection, outreach campaigns, and door-to-door blood pressure screening, among others.

The key hubs of their initiative are in Iloilo, Aklan and selected areas in Northern Luzon.