TACLOBAN CITY – The Philippine Health Insurance Corporation (PhilHealth) has expanded its coverage for hemodialysis treatments to meet the growing healthcare needs of chronic kidney disease patients. The move, announced through the recently approved PhilHealth Circular 2023-0009, offers patients with stage 5 chronic kidney disease (CKD5) up to 156 sessions annually, substantially improving their access to vital treatment.
Under the new circular, eligible patients with CKD5 will receive PHP2,600 per session, totaling PHP405,600 per year. This financial assistance will be directly paid to the Dialysis Centers or Hospitals providing the treatments. The initiative is expected to alleviate the financial stress faced by many patients who require frequent dialysis treatments.
Dr. Rosario Suyom, head of PhilHealth-8's healthcare delivery management division, highlighted that some patients needed more than the initially provided 90 sessions per year due to financial constraints. This prompted approving an additional 12 sessions, ensuring patients receive the necessary care without added financial strain.
Individuals must be registered PhilHealth members and included in the PhilHealth dialysis database to benefit from the extended package. As of June 2023, PhilHealth has already disbursed PHP191,048,856.12 for 54,584 claims/sessions in the entire Eastern Visayas region. A significant portion, 65.8%, has been allocated to Leyte, amounting to PHP125.73 million for 36,564 claims.
Around 50,000 patients in Region 8 have been granted the "expanded package coverage" for CKD5. According to Dr. Suyom, this procedure has consistently been among the top 10 most reimbursed procedures by PhilHealth-8 since the implementation of "all case rates" in 2012. While specific data for hemodialysis utilization in 2022 is not yet available, Dr. Suyom noted that it continues to be one of the leading procedures performed in the region following pneumonia.
Chronic kidney disease remains a significant health concern in the Philippines, prompting the Department of Health to emphasize regular check-ups and lifestyle changes to protect kidney health. The expanded coverage for hemodialysis sessions was approved on June 22, increasing the yearly session limit from 90 in 2020 to 156 in 2023.
Currently, 117 Health Care Providers-Institutions are accredited under the Tacloban-Local Health Insurance Office to administer the covered treatments, providing patients in Eastern Visayas with better access to essential healthcare services. —iTacloban (Source: CIO)