Western Visayas hospitals call for quick release of reimbursements from PhilHealth

Yasmin Pascual Dormido, ABS-CBN News

Posted at Aug 13 2020 04:43 PM

Delays in the payout to hospitals via the Interim Reimbursement Mechanism of PhilHealth will impact the medical services of these hospitals, including those for COVID-19 patients. Photo courtesy of the Corazon Lacson Montelibano Memorial Regional Hospital

BACOLOD -- Medical directors of both government and private hospitals in Bacolod City are asking lawmakers to look into the situations of Western Visayas medical institutions after the Philippine Health Insurance (PhilHealth) announced that the release of reimbursements to these hospitals through the Interim Reimbursement Mechanism (IRM) for COVID-19 cases will be delayed.

Dr. Julius Drilon, Medical Center Chief II of the Corazon Locsin Montelibano Memorial Regional Hospital (CLMMRH), said inefficiency on the part of PhilHealth will further delay the reimbursements of hospitals. 

Drilon explained that it takes an average of 41 to 45 days before a hospital can be reimbursed. If a hospital has no IRM now, Drilon said it cannot replenish funds that were previously used in its operations. He added they will have to wait for another 60 days before they can replenish the funds spent.

He said hospital expenses have gone up by 35-40 percent because of other measures taken, particularly in infection control, and the cost of patient care has risen.

“At the rate we’re going now, we are walking in a very thin line, balancing our expenses and also augmenting our other sources of income to support other operations. Electricity rate has gone up. Second, we have to hire extra people to replace our people that are quarantined because of COVID-19 exposures, so, at the end of the day, if we cannot sustain this operation, we just have to choose the number of beds that we will allocate to our non-COVID patients. We might even shut down some of the areas. The implication here is not just money but the social impact and the health impact to the community,” said Drilon.

Drilon said the delay in the processing and release of the IRM has a tremendous impact on all healthcare institutions in Region 6.

“The total reimbursement of CLMMRH as of end of July has gone up to P153 million. So, without IRM, we will have a hard time in the coming months to sustain our operation. So, if they can only make our reimbursements faster, if PhilHealth Western Visayas can improve their administrative process, they can help us, not only us, but other hospitals as well, to manage and in addressing COVID-19 patients in our institutions. We have brought this issue to the attention of our senators and congressmen,” added Drilon.

Bacolod Queen of Mercy Hospital Medical Director Dr. John Alejano said the non-inclusion of Western Visayas hospitals in the IRM is a very big blow to efforts in fighting COVID-19 because the fund is needed at this time to finance the operations of all hospitals, specifically in admitting patients, operation of laboratories, testing of COVID-19 suspects and other activities that are necessary during the pandemic.

He said the absence of funds for now will hamper hospital operations.

“How can we pay our suppliers on time? How can we, of course we are running operations, we have operating expenses to deal with. So, it will be hampered. And of course, we are paying our staff. These will be slowing down our operations,” said Alejano.

Alejano said private hospitals are now suffering from revenue losses. The absence of much-needed funds, according to him, will even make it harder for hospitals to operate.

“So, if you’re a 120-bed hospital, which previously admitted patients at around 80-90 percent capacity, we just have 25 percent, for now only 25-percent full. So there is revenue slow down and cash flow, revenue loss. So, where will we get our funding to operate, especially to take care of patients with COVID-19 and some of them are in critical and high-risk conditions, so we have to look into that,” added Alejano.

Drilon of CLMMRH hopes political leaders can take a serious look at the issue because health institutions, according to him, cannot operate without the promised financial support from the government. 

Bacolod Rep. Greg Gasataya earlier wrote a letter to the president and CEO of PhilHealth requesting that they settle the problem regarding the claims of CLMMRH so that the regional hospital can use the funds for its COVID-19 response.