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Capitol-run hospitals to partner with HMOs
By: Vanessa Almeda | Published Wednesday, October 14, 2020
The Cebu Provincial Government partners with Health Maintenance Organizations (HMO) in ensuring the health and wellness of the Cebuanos. (Lito Tecson)

Private individuals who are insured and are members of private health insurance companies can soon avail of the services of the 12 district hospitals and four provincial hospitals in Cebu.

Considered another landmark undertaking spearheaded by Governor Gwendolyn Garcia, health care facilities run by the Cebu Provincial Government will be partnering with Health Maintenance Organizations (HMOs) and insurance companies.

A memorandum of agreement is being finalized and is expected to be signed this month.

During the meeting she called Tuesday, October 14, Garcia said this undertaking is another landmark agreement for Cebu as the Province will tap the private sector as partners in ensuring the health and wellness of its constituents.

The initiative is also seen as timely and in keeping with the Philippine Health Insurance Corporation’s (Philhealth) vision of “convergence” with the private health insurance sector especially in this time of the Covid-19 pandemic, said Philhealth-Central Visayas Acting Vice President Arlan Granali. 

The governor called for a meeting with private health insurance companies two weeks ago to discuss the Province’s desire to open its hospitals to them. 

In that meeting, it was agreed that a memorandum of agreement will be drafted so the partnership “will be well defined.” 

“From there, we agreed a MOA will be drafted so that that this relationship will be well defined, there is no confusion aron way gubot unya. That’s the way the Province operates. Di mi magdali-dali, dili sad mi mosud sa usa ka butang unya lain sunod nga adlaw,” Garcia said in Tuesday’s meeting.

Once the agreement is signed, insured beneficiaries and cardholders of HMOs who are residents of Cebu’s towns and cities may avail of the medical and health services available in the nearest provincial or district hospitals in their areas.

This way, they will no longer have to go to Cebu City just to avail of the health services in private hospitals.

“Kadaghanan karon sa atong mga hospitals sa probinsya ang gidawat kana raman indigents. Kun naa man private patients mu-sud, mobayad man na siya although naa man Philhealth. Pero kini nga agreement, kanang mga private companies nga gi-cover nila empleyado og private health insurers, ug ila mga pamilya tua sa probinsya mostly, maka-avail na aning services sa atong provincial and district hospitals,” Provincial Attorney’s Office Chief Atty. Donato Villa said.

Maxicare Assistant Vice President for Medical Services Dr. Erwin Noche was elated and enthusiastic of this development that realized their goal of expanding their services outside the city.

“This is a dream come true because we have been in the business for so many years already and our challenge is, of course, getting affiliated providers in areas outside of the city because we have clients outside of the city, kadto dependents nang ating mga clients diri so they need a hospital nga pwede sila maka-avail ng mga services nila dito,” he said.

One of the initial points agreed was the required cash bond that HMOs will have to place, amounting to P200,000.

Villa said the cash bond is required as security for the Province of Cebu in case the HMOs or the insurer files a default, unable to pay the accounts due, or worse, goes bankrupt.

“We are not a private company, we are with the government. Pananglitan, duna’y paninglonon, kami mo’y paninglan sa COA (Commission on Audit). So mao na for assurance, worse comes to worst, inyong kumpaniya simbako lang ma-backlog or di mo makabayad sa inyohang payables sa Province, we have somewhere to go. Ari namo sa inyong bond kuhaon kay lisud man sad og ingon anion, pananglitan di mo kabayad, ang signatory ani mao may gukdon sa COA,” Villa said.

Noche said they agree to the required bond but expressed the need of their company to study the proposition first.

“If it is the requirement of government then we will study it. We will do some actuarial study on it. But in principle yes, because we also need affiliated providers in the outskirts especially the provincial (and district) hospitals that we have, like in Camotes and other areas,” he said. (Vanessa L. Almeda)