{"id":987786604,"date":"2025-09-30T12:12:10","date_gmt":"2025-09-30T11:12:10","guid":{"rendered":"https:\/\/p4h.world\/?post_type=news&#038;p=987786604"},"modified":"2025-09-30T12:12:28","modified_gmt":"2025-09-30T11:12:28","slug":"philhealth-explores-data-driven-overhaul-of-hospital-payments-for-universal-healthcare","status":"publish","type":"news","link":"https:\/\/p4h.world\/en\/news\/philhealth-explores-data-driven-overhaul-of-hospital-payments-for-universal-healthcare\/","title":{"rendered":"Philhealth explores data-driven overhaul of hospital payments for universal healthcare"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; admin_label=&#8221;!!! PLEASE DO NOT EDIT !!!&#8221; _builder_version=&#8221;4.19.5&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row admin_label=&#8221;!!! PLEASE DO NOT EDIT !!!&#8221; _builder_version=&#8221;4.19.5&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.19.5&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text admin_label=&#8221;TO BE EDITED &#8211; SUMMARY &#8211; Click on the WHEEL icon to open the textarea where you can paste or type your summary. The summary condenses the main points for the news that starts below. The summary is in bold and not longer than 300 characters, including spaces. The counter at the bottom can help.&#8221; _builder_version=&#8221;4.21.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||20px||false|false&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"prose text-pretty dark:prose-invert inline leading-relaxed break-words min-w-0 [word-break:break-word] prose-strong:font-medium\">\n<div class=\"prose text-pretty dark:prose-invert inline leading-relaxed break-words min-w-0 [word-break:break-word] prose-strong:font-medium\">\n<p class=\"my-2 [&amp;+p]:mt-4 [&amp;_strong:has(+br)]:inline-block [&amp;_strong:has(+br)]:pb-2\"><strong>Philippine health officials, with support from Thailand\u2019s NHSO and the World Bank, are studying global budgets, DRG systems, and electronic claims to cut out-of-pocket costs and advance universal health care. Lessons from Thai hospitals aim to guide PhilHealth\u2019s DRG transition by 2025.<\/strong><\/p>\n<\/div>\n<\/div>\n<p>[\/et_pb_text][et_pb_text admin_label=&#8221;TO BE EDITED &#8211; TEXT OF THE NEWS &#8211; BLOCK 1 &#8211; Click on the WHEEL icon to open the textarea where you can paste or type your news. PLEASE USE ONLY THE FEATURED IMAGE FUNCTION on your right column to add the image.&#8221; _builder_version=&#8221;4.21.0&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||1em||false|false&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<div class=\"prose text-pretty dark:prose-invert inline leading-relaxed break-words min-w-0 [word-break:break-word] prose-strong:font-medium\">\n<p class=\"my-2 [&amp;+p]:mt-4 [&amp;_strong:has(+br)]:inline-block [&amp;_strong:has(+br)]:pb-2\">Philippine health experts and government agencies are looking to strengthen the country\u2019s capacity to deliver universal health care by modernizing provider-payment systems, adopting global budgets, and improving hospital information systems. In late August 2025, the Philippine Institute for Development Studies-Health Economics and Finance Program (PIDS-HEFP) joined the Department of Health (DOH), <a href=\"https:\/\/www.philhealth.gov.ph\">PhilHealth<\/a>, and the Commission on Audit (COA) in a bilateral dialogue with Thailand\u2019s <a href=\"https:\/\/eng.nhso.go.th\/view\/1\/Home\/EN-US\">National Health Security Office (NHSO)<\/a> in Bangkok. The event, co-organized with the World Bank, drew <a href=\"https:\/\/www.philhealth.gov.ph\/news\/2022\/drg_closer.pdf\">lessons<\/a> from Thailand\u2019s reforms that can serve as models for the implementation of a Diagnosis Related Group (DRG) inpatient classification system mandated under the Philippine Healthcare Act.<\/p>\n<p class=\"my-2 [&amp;+p]:mt-4 [&amp;_strong:has(+br)]:inline-block [&amp;_strong:has(+br)]:pb-2\">Thailand\u2019s experience in pairing DRGs with regionally allocated global budgets stood out as a potential framework for adapting the Philippine system. Thai officials demonstrated how electronic transfers, through the Smart Money Transfer system, support timely and accurate healthcare claims, while layered audits enforce accountability, protect budgets, and improve data quality. Delegates also explored how Thailand ensures fairness and efficiency in health service delivery, including measures like no-balance-billing policies, no-fault patient compensation mechanisms, and strict penalties for late claims submission.<\/p>\n<p class=\"my-2 [&amp;+p]:mt-4 [&amp;_strong:has(+br)]:inline-block [&amp;_strong:has(+br)]:pb-2\">The Philippine delegation visited the Thai Case-Mix Center and Bang Pa-In Hospital to observe DRG applications along the patient care journey, examining their role in governance, audit mechanisms, and hospital operations. This hands-on exposure reinforced how provider-payment reforms directly shape hospital performance and patient access.<\/p>\n<p class=\"my-2 [&amp;+p]:mt-4 [&amp;_strong:has(+br)]:inline-block [&amp;_strong:has(+br)]:pb-2\">This initiative builds on a 2023 PhilHealth-PIDS study tour to Thailand, which had already begun providing technical guidance for the Philippines\u2019 transition to DRGs. The most recent dialogue extended discussions to involve more stakeholders, including hospitals and professional societies, to ensure that reforms are both technically sound and contextually adapted. Ultimately, these engagements aim to reduce Filipinos\u2019 out-of-pocket payments, strengthen financial sustainability, and enable a smoother shift toward universal health care delivery.<\/p>\n<\/div>\n<p>[\/et_pb_text][et_pb_text admin_label=&#8221;TO BE EDITED &#8211; TEXT OF THE NEWS &#8211; BLOCK 2 &#8211; Click on the WHEEL icon to open the textarea where you can paste or type your news. PLEASE USE ONLY THE FEATURED IMAGE FUNCTION on your right column to add the image.&#8221; _builder_version=&#8221;4.21.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Philippine health officials, with support from Thailand\u2019s NHSO and the World Bank, are studying global budgets, DRG systems, and electronic claims to cut out-of-pocket costs and advance universal health care. Lessons from Thai hospitals aim to guide PhilHealth\u2019s DRG transition by 2025. Philippine health experts and government agencies are looking to strengthen the country\u2019s capacity&#8230;<\/p>\n","protected":false},"author":2098,"featured_media":987786607,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":""},"categories":[],"tags":[122,134,3046,3042],"acf":[],"_links":{"self":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news\/987786604"}],"collection":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news"}],"about":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/types\/news"}],"author":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/users\/2098"}],"replies":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/comments?post=987786604"}],"version-history":[{"count":3,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news\/987786604\/revisions"}],"predecessor-version":[{"id":987786621,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/news\/987786604\/revisions\/987786621"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/media\/987786607"}],"wp:attachment":[{"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/media?parent=987786604"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/categories?post=987786604"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/p4h.world\/en\/wp-json\/wp\/v2\/tags?post=987786604"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}