A new private network of primary-care clinics is trying to step into an enormous gap left by the Philippines public-care facilities.
The gap in care in the Philippines has opened in spite of a broad government health insurance program that claims to cover 91 percent of the population. But only 10 percent has actually been able to receive care under the program, according to Dr. Jaime Galvez Tan, a trustee at the non-governmental organization HealthJustice Philippines and a former Philippine Department of Health secretary and undersecretary. On the Philippine island of Samar, Galvez Tan notes, the entire population is listed as enrolled in the government program. “But there are no health facilities there,” he says. Elsewhere in the country facilities tend to be grossly inadequate to care for the local population, he adds.
As a result, most of the population gets care through private clinics and non-medical providers, according to a 2016 study by the International Finance Corporation (IFC). The private sector already makes up 50 percent of the entire health system in the Philippines.
Ayala Healthcare Holdings, a subsidiary of Filipino company Ayala Corp., plans to be a major player in that system, launching FamilyDOC as an integrated health clinic, diagnostic facility and pharmacy. The company has opened four integrated clinics since 2015, and aims to open another 95 clinics over the next three years.
The main opportunity is providing conveniently located care, says Paul Darroca, deputy general manager of Ayala Healthcare. “About 75 percent of our customers are within a 1-kilometer radius around the clinic,” he notes. “The first thing people list as a reason why they go to FamilyDOC is because it’s near where they live.” Darroca claims the pilot clinics are seeing up to triple the number of patients a new clinic typically sees in its first year. Some 22,000 patients have registered with FamilyDOC so far, he says, at a cost of US$8 (400 Philippine pesos).
Ayala is also enlisting service integration as a competitive edge. Health service delivery was transferred from federal to local governments in the Philippines in 1991, leading to a fragmented network of healthcare administration. Patients bear the brunt of this disorganization, particularly when it comes to tracking and transferring individual medical records. The mix of private and public healthcare facilities exacerbates the problem, says Marilyn Lorenzo, a physician and researcher with the Philippines Department of Health Policy and Administration. “Private sector companies are providing state-of-the-art hospital care,” she says, “but they’re not well-integrated into a referral system with primary care public facilities, and that creates a big gap.”
Ayala is trying to avoid that problem by bringing more services to patients within its network. The company has purchased stakes in Wellbridge Health, the owner of online pharmacy MedGrocer, in the pharmacy chain Generika, and has entered into a joint venture with the Mercado Group to operate the hospital and health clinic chain QualiMed. Now the company is looking at more investments in the hospital and financing spaces, and is currently developing a proprietary electronic medical record (EMR) system. It has also entered into a collaboration with GE Healthcare, which has helped Ayala with continuing the education of doctors and staff, as well as equipment discounts, according to Dr. Michael Santos, medical director of Ayala Health.
It’s too early to see trends in health outcomes among FamilyDOC patients. But Santos notes that 70 percent of first-time patients come back for a follow-up visit with a doctor within a week. That’s a good early indication that patients are becoming committed to their care there. And when it comes to improving healthcare, getting patients to keep coming to primary care is often more than half the battle.
— Annie Zak
Annie Zak is a freelance writer based in Anchorage, Alaska.