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2010 Stats & Charts2010 Stats & Charts2010 Stats & Charts2010 Stats & ChartsPHILIPPINE HEALTH INSURANCE CORPORATION
Updated as of March 1 2011Updated as of March 1, 2011
MembershipMembership
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)
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
MembershipMembershippp
M indanao NCR & NorthM indanao22%
NCR & North Luzon41%
South Luzon & VisayasVisayas
37%
Source: MMG
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
Premium Premium CollectionsCollections
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
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%
Benefit Benefit e e te e tPaymentsPaymentsyy
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
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%
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.
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%
Claims ProcessingClaims Processinggg(Number of Claims Paid Per Area)
January-December 2010
Mindanao 29% NCR & North
LuzonLuzon40%
South Luzon & Visayas& Visayas
31%
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%
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
AccreditationAccreditation
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
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
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
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
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
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