Module 7 Uhc 2024
Module 7 Uhc 2024
Module 7 Uhc 2024
Method of paying health care providers based on the number of people within their catchment area:
a. Capitation
The following reflects the major steps in the management of the Special Health Fund:
a. creation; planning and budgeting; disbursement and utilization; monitoring, transparency and accountability
The general term for the way PhilHealth will pay health care providers for services delivered to the covered population:
a. Provider-Payment Mechanism
The management of the Special Health Fund is being monitored through the Local Health Systems Maturity Levels under the
following P/CWHS characteristic:
a. Financial Management
The following serve as the bases of the Provincial and City Health Board for the planning and budgeting of the Special Health
Fund:
The provision of regular meal, bed in shared room, fan ventilation, and shared toilet and bath during hospital confinement:
a. Basic accommodation
A patient who opt for non-basic accommodation is charged a form of co-payment for hospital services, professional fees, and
fringe or additional amenities. The following are considered as examples of fringe or additional amenities:
The following member categories are covered by the current No Balance Billing (NBB) policy, EXCEPT:
All health care providers shall comply with the prescribed allocation of basic and non-basic accommodation within their facilities.
Which of the following bed ratios stated in the Universal Health Care Act is correct?
a. All private hospitals shall allocate 10% of their approved bed capacity to basic accommodation.
The agency responsible to develop monitoring tools to track the implementation of the No Co-Payment Policy:
The following are the possible sources of funds for the Special Health Fund:
The least effective method of paying health care providers in terms of driving efficiency, as this motivates providers to over-
provide services:
a. Fee-for-service
The following are the allowable expenses for the Special Health Fund, EXCEPT:
a. The Joint Memorandum Circular on Special Health Fund provided the minimum fund level that will be allocated for
equity purposes.
This entity has the full responsibility in the management of the Special Health Fund:
a. Provincial/City Health Board
The Special Health Fund shall be maintained at the following LGU levels that committed to integrate, EXCEPT:
a. Component Cities
The appropriation of the budget from the following LGU fund requires an ordinance passed by the Sanggunian:
a. General Fund
Method of paying health care providers based on bundling together sets of health services and resources into single payment
amounts:
a. Case-based payments
Method of paying health care providers based on classifying cases into a group with the same characteristics in terms of
diagnoses, procedures, and expected resource use:
a. Diagnosis-related groups
The number assigned to each DRG that reflects resource intensity based on collected cost data:
The implementation of the Global Budget by PhilHealth will be based on the following:
The provision of minimum standards of care for patients including fringe or additional amenities at the option of the patient
during hospital confinement:
a. Non-basic accommodation
Method of paying health care providers based on a lump sum amount paid prior to an agreed-upon time period:
a. Global Budget
a. Co-payment
The following document is the primary basis for the transfer of funds from DOH to the LGU:
a. Terms of Partnership
The direct payment of a portion of health care costs by an insured person when receiving health services:
a. Cost-sharing
The No Co-Payment policy will remain in effect in the provision of the following PhilHealth benefit packages during the transition
period of shifting from No Balance Billing policy to No Co-payment policy:
The following correctly differentiates No Balance Billing policy from No Co-Payment policy:
a. The No Balance Billing policy is based on membership categories whereas the No Co-Payment policy is based on the
hospital accommodation type.
Method of paying health care providers based on bundling together sets of health services and resources into single payment amounts:
A. Case-based payments