Contract on Z Benefits for renal illnesses patients inked

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Tuesday, July 22, 2014

KIDNEY transplant surgery is expensive.

With this, the Philippine Health Insurance Corporation (PhilHealth) and the Northern Mindanao Medical Center (NMMC) signed an agreement Monday to provide a new privilege under the Z Benefits Package (ZBP) for patients with renal diseases, particularly the indigents in Northern Mindanao.

Datu Masiding M. Alonto Jr., PhilHealth regional vice president, said the ZBP will now be offered at the NMMC where patients who are members of PhilHealth and their dependents can avail themselves of a financial risk protection when needing the kidney transplant procedure.


“Members can save up the high cost of fatal kidney-related illnesses with the help of the new program. The Z Benefits package is being offered to address health conditions that trigger prolonged hospitalization and very expensive treatments," Alonto said.

Alonto said the contract with NMMC is the second in Mindanao owing to the increasing need of renal patients who want to prolong their lives through transplantation.

“This is a milestone for NMMC to widen its services especially to PhilHealth members and their dependents with kidney failure, especially those from poverty stricken households, who can now avail of a transplant procedure and look forward to productive and fuller lives,” Alonto said.

PhilHealth will shoulder the expenses under ZBP of up P600,000 per patient with no balance billing.

The regular cost of kidney transplant is at P800,000 to P1 million.

Dr. Jose Chan, NMMC chief of hospital, said with the PhilHealth contract, they can now look forward to renal patients needing kidney transplantation without reservation with regard to cost for as long as they are PhilHealth members.

According to Dr. Ethel Ricardo, PhilHealth's Health Care Delivery and Management Division (HCDMD) head, all eligible PhilHealth members (whether under the employed sector, individually paying, lifetime member program, sponsored program, or overseas workers program categories) including their qualified dependents are entitled to avail themselves of the package.

"In cases that the surgery exceeds the allocated budget, the patient will only pay the excess amount. But it depends on the financial standing of the patient's family," Ricardo said of the poor patients. "The evaluation of the standing will be conducted by the social service workers of PhilHealth."

Under Z Benefits, kidney transplant is identified as catastrophic illness. PhilHealth classifies disease conditions from type A (the simplest and cheapest) to type D (the more severe and costly).

The package includes hospital room and board fees, drugs and laboratory exams, operating room and professional fees for the entire course of treatment.

The NMMC is the second contracted hospital of PhilHealth in Mindanao to offer kidney transplant. The Southern Philippines Medical Center in Davao City was the first.

NMMC, authorized by the National Kidney Institute to perform and provide kidney transplant services, has already served 11 patients to date. And all the procedures were successful.

Chan said that not all PhilHealth member kidney patients can avail themselves of the ZBP considering there are those who can afford. Instead, they will be required to give their share of the cost after the benefits derived from PhilHealth.

“We will carefully assess patients and determine their capability to pay so that we can maximize the benefit of the ZBP for the indigents,” Chan said.

He said NMMC has surpassed its targeted patient population that it needs to expand its services to accommodate the various cases.

Chan said they now have strict policy prohibiting their patients to buy medicines from outside NMMC. “We will provide it for them, because it is not an excuse for NMMC not to avail patients of their medicines due to the constraints in the procurement processes.”

Leading causes

The leading causes of kidney failure among Filipinos are diabetes, inflammation of the kidneys and high blood pressure.

To live longer, patients with end-stage renal disease have only two treatment options -- to undergo lifetime dialysis and one-time kidney replacement.

“Both options are costly that 25 percent of Filipino patients die every year without receiving treatment, thus PhilHealth introduced this new benefit since we feel that it is not proper to deprive Filipinos of what is due them – a quality health care,” Alonto said.

However, the PhilHealth-NMMC agreement will be effective the moment the chief executive officer of PhilHealth will sign the agreement, Chan said.

"This is indeed a milestone. This is just the beginning of many partnerships," Alonto said, hoping that coronary artery bypass graft surgery and other operations will come in the next months.

On June 21 this year, operations for acute lymphocytic leukemia, breast cancer and prostate cancer were also entered into agreement earlier between the same institutions.

At present, there are 23 contracted hospitals nationwide for the Z Benefits program. All of them are government tertiary institutions.

Published in the Sun.Star Cagayan de Oro newspaper on July 22, 2014.

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