2010 Stats & Charts2010 Stats & Charts · 2010 Stats & Charts2010 Stats & Charts PHILIPPINE HEALTH...

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2010 Stats & Charts 2010 Stats & Charts 2010 Stats & Charts 2010 Stats & Charts PHILIPPINE HEALTH INSURANCE CORPORATION Updated as of March 1 2011 Updated as of March 1, 2011

Transcript of 2010 Stats & Charts2010 Stats & Charts · 2010 Stats & Charts2010 Stats & Charts PHILIPPINE HEALTH...

Page 1: 2010 Stats & Charts2010 Stats & Charts · 2010 Stats & Charts2010 Stats & Charts PHILIPPINE HEALTH INSURANCE CORPORATION Updated as of March 1 2011Updated as of March 1, 2011 ...

2010 Stats & Charts2010 Stats & Charts2010 Stats & Charts2010 Stats & ChartsPHILIPPINE HEALTH INSURANCE CORPORATION

Updated as of March 1 2011Updated as of March 1, 2011

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MembershipMembership

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NHIP EnrollmentA f D b 2010

NHIP EnrollmentA f D b 2010

Sector Registered Estimated

As of December 2010As of December 2010

Sector Members* Beneficiaries**Government-Employed 1.95 6.58

Private-Employed 7.86 22.63

Sponsored Program 6 04 22 10

74% of the Population are Sponsored Program 6.04 22.10

Individually-Paying 3.75 10.92

Lifetime Members 0.50 0.85Overseas Workers

2 34 6 90

pnow enrolled in the Program . . . . .

Program2.34 6.90

Total 22.44 69.98Notes:

*Based on MMG report. (numbers are in millions)( )

**Estimates are based on member-dependent ratio as computed by the BDR study. (numbers are in millions)

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Membership (by Sector)Membership (by Sector)p ( y )As of December 2010

p ( y )As of December 2010

OWP

Sponsored27%

OWP10%Lifetime

2%

IPP17%

Private35%

17%Gov't

9%

Source: MMG

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MembershipMembershippp

M indanao NCR & NorthM indanao22%

NCR & North Luzon41%

South Luzon & VisayasVisayas

37%

Source: MMG

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Registered Members (by PhRO)As of December 2010

Registered Members (by PhRO)As of December 2010As of December 2010As of December 2010

1 073417 4,553

N C R

C A R

1

1,0891,474

5801,0731

2

3 A

3 B

1 6141,038

1,221

1,8824 A

4 B

5

529

9311,6091,6146

7

8

9

* in thousands601

1,0011,202

1,31110

11

12

316601C araga

A R M M

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Premium Premium CollectionsCollections

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Premium Collections (by Sector)Premium Collections (by Sector)Premium Collections (by Sector)As of December 2010

Premium Collections (by Sector)As of December 2010

C ll tiSector Collections(in million pesos)

Government-Employed 6,703.3

Private-Employed 17,944.6

Sponsored Program 2,005.9

Individually-Paying 1 666 1 Individually Paying 1,666.1

Overseas Workers Program

767.7

Total 29 087 7Source: Financial Statements

Total 29,087.7

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Premium Collections (by Sector)Premium Collections (by Sector)

SponsoredOWP

( y )As of December 2010

( y )As of December 2010

IPP6%

Sponsored7%

OWP3%

Gov't23%Private

61%

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Benefit Benefit e e te e tPaymentsPaymentsyy

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Benefit Payments (by Sector)Benefit Payments (by Sector)Benefit Payments (by Sector)As of December 2010

Benefit Payments (by Sector)As of December 2010

Sector Benefit PaymentSector(in million pesos)

Government-Employed 5,458.6

Private-Employed 11,083.5 p y ,

Sponsored Program 6,634.1

Individually-Paying 4,419.5

Lifetime Members 1 968 6 Lifetime Members 1,968.6

Overseas Workers Program

948.9

T t l 30 513 1Source: Financial Statements

Total 30,513.1

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Benefit Payments (by Sector)Benefit Payments (by Sector)

Lifet ime

Benefit Payments (by Sector)As of December 2010

Benefit Payments (by Sector)As of December 2010

Spo nso red22%

OWP3%

6%

P rivate37% IP P

14%

Go v't18%

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Claims ProcessingClaims Processing(Number of Claims Paid and AVPC Per Sector)

January to December 2010

Claims ProcessingClaims Processing

Sector Number AVPCAll Sectors 3,479,453 7,930 Government 606 677 8 068Government 606,677 8,068 Private 1,157,145 8,231 IPP 658,076 7,374 OWP 105 734 8 870OWP 105,734 8,870 Sponsored Program 732,313 7,301 Lifetime 219,506 9,268 Notes:

Source: Paid Claims Database

1. Derivation of AVPC is based on amount and number of claims paid as recorded in the paid claims database.2. Data extracted on January 8, 2011.

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Claims ProcessingClaims Processing(N b f Cl i P id P S t )

Lif ti M b

gg(Number of Claims Paid Per Sector)

January-December 2010

Sponsored Program Members

Lifetime Members6% Government

17%

21%

OWP3%

Private34%

IPP19%

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Claims ProcessingClaims Processinggg(Number of Claims Paid Per Area)

January-December 2010

Mindanao 29% NCR & North

LuzonLuzon40%

South Luzon & Visayas& Visayas

31%

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Claims ProcessingClaims Processing(Benefit Item Distribution)

R & B d

(Benefit Item Distribution)January-December 2010

Prof. Fees24%

Room & Board16%

OR Fee6%

Drugs & Meds29%

X-Ray /Lab/Others/Lab/Others

25%

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Claims ProcessingClaims Processing(T 20 Ill R k d b N b f Cl i P id)(Top 20 Illnesses Ranked by Number of Claims Paid)

January-December 2010Rank Ilness Total Amount

(in millions) # Claims

1 Pneumonia, organism unspecified 2,042.4 295,390 2 Chronic renal failure 1,039.4 261,131 3 Diarrhoea and gastroenteritis of presumed infectious origin 837.9 205,707 4 Single spontaneous delivery 867.6 182,688 5 Other disorders of urinary system 635.1 125,319 6 Liveborn infants according to place of birth 175.4 113,484 7 Essential (primary) hypertension 395.8 77,900 8 Dengue haemorrhagic fever 613.9 71,611 9 Acute upper respiratory infections of multiple or unspecified sites 334.5 69,492

10 Senile cataract 1,010.9 66,347 11 A th 330 5 58 68111 Asthma 330.5 58,681 12 Gastritis and duodenitis 267.0 56,425 13 Dengue fever [classical dengue] 297.4 47,643 14 Typhoid and paratyphoid fevers 322.7 46,866 15 Chronic nephritic syndrome 215.8 44,973 16 Malignant neoplasm of breast 270 8 43 26916 Malignant neoplasm of breast 270.8 43,269 17 Amoebiasis 201.7 43,101 18 Acute bronchitis 204.5 40,467 19 Single delivery by caesarean section 811.1 38,625 20 Viral infection of unspecified site 142.3 33,350

Source: Paid Claims DatabaseSource: Paid Claims Database

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AccreditationAccreditation

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AccreditationAccreditationAs of December 2010As of December 2010

Facilities AccreditedFacilitiesHospitals 1,602

Ambulatory Surgical Clinics 59

Rural Health Units 1,404

Authorized Hospitals 116

Free-standing Dialysis Clinics 56Free standing Dialysis Clinics 56

TB-DOTs Centers 813

Maternity Care Clinics 742

Sources: HIS, Accreditation Department

Professionals 21,338

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Accreditation (Hospital Type)Accreditation (Hospital Type)( p yp )As of December 2010

( p yp )As of December 2010

Gov't40%40%Private

60%

89% of almost 1,800 DOH-licensed hospitals are accredited by PhilHealth

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Accreditation (Out-Patient Facilities)A f D b 2010

Accreditation (Out-Patient Facilities)A f D b 2010

PRO Maternity Clinics

TB DOTS Clinic

Free-standing Dialysis Clinics

Rural Health Units

As of December 2010As of December 2010

NCR-CENTRAL 29 14 27 57NCR-NORTH 33 6 21 34NCR-SOUTH 78 6 37 39CAR 73 2 53 11I 113 4 67 18I 113 4 67 18II 47 0 38 16III-A 84 5 4 45III-B 58 3 3 29IV-A 39 1 30 55IV B 87 2 15 23IV-B 87 2 15 23V 90 2 42 24VI 125 3 129 69VII 102 2 82 54VIII 118 0 73 94IX 64 0 41 27X 75 1 45 44XI 36 3 23 47XII 32 0 34 26CARAGA 68 2 20 12ARMM 53 0 29 18TOTAL 1,404 56 813 742

Source: Accreditation Dept

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Accreditation (Professionals)Accreditation (Professionals)Accreditation (Professionals)As of December 2010

Accreditation (Professionals)As of December 2010

Professional NumberGeneral Practitioner 9,823Medical Specialist 10,981Dentist 180Midwife 354

Grand Total 21,338G a d ota ,338Source: HIS

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Accredited Collecting Agents (ACAs)Accredited Collecting Agents (ACAs)

ACA B h

Accredited Collecting Agents (ACAs)As of December 2010

Accredited Collecting Agents (ACAs)As of December 2010

ACAs BranchesUniversal Banks 13 2,676 C i l B k 5 324Commercial Banks 5 324 Thrift Banks 10 422 Rural Banks 15 260Rural Banks 15 260 Cooperative Bank 1 4 Non-Bank 40 3 808

• 84 active collecting agents with more than 7 000 branches nation ide

Non-Bank 40 3,808

7,000 branches nationwide