SPMC's PhilHealth share: With great income, comes greater allocation

Dr. Leopoldo “Bong” Vega, former Southern Philippines Medical Center (SPMC) Chief and now Undersecretary for Special Concerns of the Department of Health (DOH) reacts to the reports that SPMC received the biggest amount of compensation under the Philippine Health Insurance Corporation’s (PhilHealth) Internal Reimbursement Mechanism (IRM) for the treatment of coronavirus patients. Vega said SPMC has the highest PhilHealth income breaking the billion mark. Edge Davao

In simple equation: the more income, the more allocation.

That is how Health Undersecretary Leopoldo “Bong” Vega, who was at the helm of the Southern Philippines Medical Center (SPMC) explained in a nutshell why the Davao City hospital got more allocation from the embattled Philippine Health Insurance Corporation’s (PhilHealth).

Reacting to the Rappler’s report that Southern Philippines Medical Center (SPMC) received the biggest amount of compensation under the Philippine Health Insurance Corporation’s (PhilHealth) Internal Reimbursement Mechanism (IRM) for the treatment of coronavirus patients, Vega said SPMC has the highest PhilHealth income which breaches the billion peso mark. 

Vega in a text message said SPMC generated an average of P1.2 billion for 2018 to 2019. 

Rappler’s controversial top journalist Maria Ressa posted a tweet on why a Davao hospital receives more than Manila’s Philippine General Hospital (PGH). 

“IRM is based on the monthly average or that track record of reimbursement for 2018 to 2019 with a yearly income from PhilHealth of P1.2 billion,” Vega said.  Vega emphasized that for 2019, SPMC has unpaid claims of P300 million from PhilHealth.

Considered the biggest public tertiary hospital in the Philippines in terms of bed capacity, SPMC caters patients not only from Davao City but the entire Mindanao as well. 

It is a 1,500-bed hospital with almost 3,600 personnel. It is considered the biggest hospital facility in the country as a government hospital. It has a total admissions of 76,586 in 2019 and a total of 586, 278 for outpatient.  

Vega stressed that SPMC has several integrated specialty buildings which are stand-alone like the Heart Institute, Institute for Women and Newborn Care, Orthopedic and Rehabilitation Institute, Cancer Institute, Intensive Care Complex, main hospital for general medicine and surgery.

SPMC also has the biggest hemodialysis with 65 dialysis chairs.

The breakdown of compensation under PhilHealth’s IRM for the treatment of coronavirus patients are as follows: Southern Philippines Medical Center in Davao City, P326 million; Philippine General Hospital in Manila, P263.3 million; Davao Regional Medical Center in Tagum City, P209 million; Vicente Sotto Memorial Medical Center in Cebu City, P204 million; Jose B. Lingad Memorial Regional Hospital in San Fernando, Pampanga, P201 million; National Kidney and Transplant Institute in Quezon City, P179 million; Baguio General Hospital and Medical Center, P165 million; Northern Mindanao Medical Center in Cagayan de Oro, P150.2 million; Quirino Memorial Medical Center in Quezon City, P150 million; and Eastern Visayas Regional Medical Center in Tacloban City, P146.2 million. 

PhilHealth’s IRM is a quick response to the calamity and in order to provide continuous health care services from the affected Health Care Institutions (HCIs) brought about by the Taal eruption, PhilHealth shall release funds under the IRM to provide substantial aid to affected HCIs in the aftermath of the calamity. The IRM is pursuant to PhilHealth Circular 34 s-2013 on the provision of special privileges to those affected by a fortuitous event.

The said funds will enable hospitals, primary care facilities, ambulatory surgical clinics, freestanding dialysis centers, and maternity care package providers to continuously provide health care services to affected Filipinos, provided that they are accredited as of December 31, 2019 and have applied for renewal for CY 2020.

More than P1 billion will be made available to affected hospitals based on a facility’s average reimbursement per day. The said release will be deductible from the computed IRM fund of the facility which can later be increased depending on the need of facilities upon request. 

In a post shared by Mon Cualoping, by allocation per region, the top five are: National Capital Region, 29.08 percent or P4.35 billion; Central Luzon, 13.07 percent or P1.96 billion; Calabarzon, 8.34 percent or P1.35 billion; Central Visayas, 7.36 percent or P1.13 billion; and Davao Region, 5.95 percent or P891 million.