The purpose of a hospital is to provide medical care to sick or injured people. However, the most talented doctors in the most modern hospitals would not be able to fulfill this purpose without an efficient system for keeping track of patients’ records.
What is the patient’s state of health? What treatments has he undergone? Who are the physicians who have treated him, and are they accredited with this hospital? Everything from the patient’s medical history to the more quotidian concerns: How is he paying for his medical care?
MEDICard, one of the leading health maintenance organizations (HMO) in the Philippines, has partnered with The Medical City, one of the most respected hospitals in the country, to make health care as hassle-free as possible to both its member patients and doctors.
Millet P. Escasinas, senior manager of The Medical City’s Relationship Management and Business Development Department, cites the benefits of the hospital’s long-running partnership with MEDICard. “Insured patients find The Medical City more safe and convenient. Other than the hospital’s renowned flagship programs, documents are all in place and different payment facilities are set up for quicker access. Medical care is therefore made easy, more convenient, and stress-free.
“HMOs have been beneficial both to the doctors and to the patients. In fact health care becomes convenient enough so patients can think ahead to health maintenance and preventive care instead of just reacting to symptoms. Promoting good health becomes a lifestyle, and detection, treatment, and rehabilitation of illness are made easy. HMOs are there to support every aspect of health care,” Escasinas adds. “As for the doctors, the systematic documentations and efficient facility supports make them even more focused in the healthcare delivery to their patients.”
Among the benefits of The Medical City’s relationship with MEDICard is the information system that allows quick access to the records of MEDICard members. “We’ve introduced the card reader service that is available in our clinics to the emergency room (ER) of The Medical City,” says MEDICard president Dr. Nicky Montoya. The card reader allows The Medical City’s ER staff to access MEDICard’s system and facilitate the member’s admission, treatment, and billing.
“MEDICard is constantly introducing innovations that make it easier for their members to avail themselves of hospital services,” Escasinas notes. “Verification of payments and other inquiries are made easier on-line.”
“A common issue in hospitals in the past was late payments to doctors by HMOs,” Dr. Montoya recalls. Part of Medicard’s automation was building strong mechanism when turnaround time for doctors’ payment was reduced to a very minimum level.”
Doctors that are affiliated with Medicard are now getting paid in just a click in the system after billing assessment & validation. At the end of the month, MDs’ bank statement contains the name of the patient, the date they availed of the service, and the amount credited to the doctor’s account. For the doctor, tracking of payments is faster and convenient.
“Everybody experiences equity in health care when you access The Medical City,” says Escasinas.
In 2004, The Medical City transferred to its present location on Ortigas Avenue in Pasig. Its former building near SM Megamall had become too small for the hospital’s requirements, and because of its location it could not expand as needed. Parking was a perennial problem, and there was always heavy traffic on the surrounding streets.
“Luckily, Medical City joined with the Lopez group to acquire this generous space,” Dr. Montoya notes.
He observes that the hospital doesn’t invest in too much technology, without considering its benefits and advantages, but the technology it does obtain is time-tested and proven reliable not the kind that only gets used once in a while. It’s a more practical approach to adopting technology.
“Our goal is to rationalize the use of technology,” Escasinas explains. “If a patient doesn’t need a particular machine, why does that patient have to pay to avail of that service?”
“Hospitals have to recover what they spend on technology,” Dr. Montoya points out. “In some cases, they have to start marketing new machines that don’t really have to be used in the patient’s care. This is not the case with Medical City.
Escasinas explains that instead of emphasizing technology or state-of-the-art facilities, The Medical City always focuses on the patient. “We are a patient-centered institution. We improve our craft in order to serve the patient. That is our culture. We encourage our patients to be actively responsible for their health. It’s not just the doctor and the hospital who decide for them, patients are very much engaged in their treatment. Other hospitals focus on technology or state-of-the-art facilities, but these concerns are secondary to us. We treat the patients as partners.”
How expensive is it to check into The Medical City? “It’s definitely not expensive,” Escasinas declares. “The main reason the facility looks like this is to provide better, more convenient service and friendly atmosphere to our patients. Throughout the hospital’s existence, the patients have always taken center stage. This hospital is really for the patients to enjoy. When they come to see their doctors it’s not a traumatic experience.”
The Medical City is accredited with PhilHealth and has various programs for indigent patients. According to Escasinas, 54 percent of patients have personal accounts with the hospital while 46 have corporate accounts. Of these corporate accounts 75 to 80 percent are HMOs.
“Based on our experience, we see the benefit of patients having HMOs,” says Escasinas. “We can see the relief on their faces, as opposed to the look on the patient who are not prepared to shell out money or doesn’t have HMO coverage. If a patient is relieved of that stress, we are relieved.
“Undergoing this state in the middle of their treatment is even more aggravating to their health conditions. Insured patients can concentrate on getting well. That alone is a big benefit.”
“We believe we’re the most HMO-friendly hospital because we understand how our industry partners think about their members,” Escasinas adds. “Each HMO is unique in how it provides services to its members. It’s the same with The Medical City: We customize the service to the patient’s need. It’s not a one-size-fits-all-relationship, but one that allows us to engage cohesively with our patients. I think MEDICard and Medical City share these similar approaches.”
As an HMO founded and run by doctors, MEDICard has an in-depth understanding of the workings of its hospital partners. This gives MEDICard a distinct advantage in addressing the needs of both its members, the patients, and its partners, the hospitals.
One result of the growing membership of HMOs in the Philippines is the heightened health conscio usness of Filipinos. “In today’s very stressful work environment, knowing that your HMO will take care of your annual physical examination which can lead to a preventive lifestyle is a great benefit,” Ms Escasinas says.