HMOs eye modest growth this year

Health maintenance organizations (HMOs) are looking at a modest growth of 10 to 15 percent in terms of total enrollees this year. Or from three million individuals in 2001 to 3.3 million this year.

In terms of membership fees, the HMOs collected approximately P4 billion in 2002, and that would mean an estimated amount of at least P4.4 billion.

"The HMO industry grew by an estimated 15 percent last year although it grew by 20 percent in 2000 compared to the previous year," Jesus Verne D. Quiazon, president of the Association of Health Maintenance Organizations of the Philippines Inc. (AHMOPI), said.

Quiazon said that the industry is looking at a modest growth of 10 to 15 percent this year. But the industry’s growth is targeted to expand by more than 300 percent in terms of real coverage by 2004. So far, the industry’s return on investments (ROI) has grown by a conservative two to three percent.

"It is estimated that by 2004, coverage will increase by 41 percent," the AHMOPI said. That forecast is broken down into six millioearmal sector employees, another 18 million in dependents, and 20 million for self-employed and its dependents.

HMOs account for 2.6 percent or P2.63 billion of the total health care expenditures in 1998 from a mere 1.23 percent seven years before.

It caters mainly to the middle market particularly those employed. But that allows the National Government to concentrate more on the lower income and unemployed portions of the population.

"We want to make health care affordable," Quiazon, who is also president and chief executive officer of PhilamCare Health Systems Inc., said.

Meanwhile, the HMOs priority efforts this year is to improve its relationship with the main medical providers, the physicians and hospitals. In fact, roughly 70 percent of its expenditures go to this sector.

It will also continue to coordinator and play a supporting role with the government Philippine Health Insurance Corp. (PhilHealth). HMOs actually provide a supplemental coverage for PhilHealth members since it only covers 30 percent of hospital expenses. — TPT