File Type
Project Document
Publication Date
12-2025
Description
This policy brief presents the findings and recommendations of the 2021–2024 process evaluation of the Philippine Health Insurance Corporation’s Konsultasyong Sulit at Tama (Konsulta) Package. The evaluation examined the program’s relevance and coherence, effectiveness, efficiency, sustainability, and equity using policy and document reviews, national administrative data, fieldwork in selected regions, interviews and focus group discussions, and a stated-preference survey and costing exercise. The findings show that Konsulta expanded rapidly in terms of beneficiary registration, provider presence, and geographic reach. However, significant gaps remain in continuity of care, access to diagnostics and medicines, private-provider participation, payment efficiency, information systems, and implementation capacity. The brief recommends shifting incentives from patient profiling toward continuous care, aligning accreditation and contracting requirements, improving payment arrangements, strengthening digital and operational systems, addressing commodity shortages, and providing targeted support to underserved areas.
Project period covered: 2021–2024
Geographic coverage: Philippines, with fieldwork in selected regions across Luzon, Visayas, and Mindanao
Research approach: Mixed-methods process evaluation
Primary policy area: Primary health care and universal health care
Recommended Citation
DLSU Social Development Research Center. (2025). Closing the Gap between Coverage and Care: Findings and Recommendations from the PhilHealth Konsultasyong Sulit at Tama (Konsulta) Process Evaluation, 2021–2024. Retrieved from https://animorepository.dlsu.edu.ph/sdrc_res_proj/18
