COST RECOVERY / PAYMENT MECHANISM FOR ASSISTIVE DEVICES IN DIFFERENT SETTINGS Josephine R. Bundoc, MD Program Director, Physicians for Peace Walking Free.

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Presentation transcript:

COST RECOVERY / PAYMENT MECHANISM FOR ASSISTIVE DEVICES IN DIFFERENT SETTINGS Josephine R. Bundoc, MD Program Director, Physicians for Peace Walking Free Philippines University of the Philippines – Philippine General Hospital

2006 – 2008 Setting : Low Awareness, Unavailable Resources, No expertise, Unaffordable Devices Strategy : Challenges : 1.Inconsistent quality and insufficient quantity of components 2.Skills and knowledge of Prosthetic-Orthotic technicians 3.Prescription and product mismatch 4.Service provision limited 5.Low utilization DONORS, NGOs GOs GOVERN MENT HEALTH FACILITY PERSON WITH DISABILITY Provided FREE Equipment, tools, supplies & components Prosthetic-Orthotic technicians Provided FREE workshop space, use of utilities Private*Charity Pays 100% FREE 100% *as recommended by Social Worker

2008 – 2014 Setting : Increased awareness, Locally available resources, Improved expertise, Unaffordable devices Strategy : Challenges : 1.Donor and subsidy sustainability 2.Prescription of device biased by capacity to pay 3.Quality control, tracking and feedback system 4.Feasible costing mechanism DONORS, NGOs GOs GOVERNMENT HEALTH FACILITY PERSON WITH DISABILITY Receives 80% income share from GHF for provision of equipment upgrade, tools, supplies, technicians’ training & salaries Receives 100% of payment & retains 20 % for workshop space rent, use of utilities and administrative work PrivateCharity* Class ABCClass D 100% payment by PWD 25-75% subsidy payment by donors,NGOs, GOs 100% FREE *as recommended by Social Worker

2015 Setting : Sustainable provision of appropriate, affordable devices Strategy : DONORS, NGOs GOs GOVERNMENT HEALTH FACILITY PERSON WITH DISABILITY Establish start up partnership for prosthetic orthotic workshop in strategic government facilities Receives 100% payment Non PhilHealthPhilHealth 100% payment or *Subsidized 25-75% by donors, NGOs, GOs No Balance Billing Option CoPay Option Challenges : 1.Ensure 100% PhilHealth membership 2.Accessibility of Government Health Facilities 3.Stakeholders compliance 4.PhilHealth Package expansion 5.Full implementation of public-private partnership *as recommended by Social Worker