The World Bank Philippines Health Financing Strengthening Integrated Safeguards Data Sheet Identification / Concept Stage (ISDS) Public Disclosure Copy Concept Stage | Date ISDS Prepared/Updated: 13-Feb-2018 | Report No: ISDSC23003 Feb 14, 2018 Page 1 of 6 The World Bank Philippines Health Financing Strengthening BASIC INFORMATION A. Basic Project Data Project ID Project Name Environmental Category Country Philippines Health P164949 C - Not Required Philippines Financing Strengthening Team Leader(s) Estimated Date of Approval Managing Unit Financing Instrument Investment Project Karima Saleh GHN02 Financing Public Disclosure Copy Financing (in USD Million) SUMMARY -NewFin1 Total Project Cost 0.00 Total Financing 0.00 Financing Gap 0.00 DETAILS -NewFin2 B. Project Development Objective(s) To strengthen Philippines Health Insurance Corporation capacity for strategic purchasing with special focus on performance monitoring and payment methods. C. Project Description As the Bank team has been able to mobilize the PHRD Bank Executed Trust Fund (BETF), and now seeking PHRD recipient executed trust fund (RETF) to finance this small grant RETF project, the two funds can provide complimentary support to the government in moving this agenda forward. The BETF will concentrate in providing policy and technical engagement and global know how. While the RETF will conduct diagnostics, implementation support and capacity building. The government of the Philippines is considering provider payment reform. It has introduced a capitation program for primary health care, and have requested assistance of others (other than WB) to provide technical assistance. The government of the Philippines has requested the assistance of the WB on a very specific area of provider payment mechanism (PPM) for hospitals. The RETF will concentrate on the payment reform side, and will consider PPM that would have implications on the following: (i) integrated care Feb 14, 2018 Page 2 of 6 The World Bank Philippines Health Financing Strengthening (between PHC and hospitals), (ii) cost containment, (iii) transparency, (iv) efficient allocations, (v) quality of care, and (vi) financial protection. The World Bank (grant) project focuses especially on strengthening capacity and systems for strategic purchasing. This World Bank (grant) project has three components: (i) strengthening key performance indicators and analytics, (ii) improving process, systems, and quality assurance mechanisms on e-claims, and (iii) supporting the hospital provider payment system reform. Component 1: Strengthening key performance indicators and analytics The component will aim to support the development of the key performance indicators (KPI) as it relates to provider and PhilHealth performance and supports the Philippines Health Agenda (PHA) at the national, local government unit (LGUs) levels, and at the Philippines Health Insurance Corporation. Public Disclosure Copy Outputs for 1  Methodological guidelines for KPI data collection and validation are developed and included in the official health sector monitoring guidelines  Baseline data of monitoring tools uploaded and available for users, including in websites of DOH, PhilHealth, and Department of Interior Local Government (DILG) has applicable  Management report using information from dashboard (or any analytic tool that will be developed)  First round of compliance assessment visits conducted by one regional office and reports and analysis produced with specific set of action recommendations Component 2: Improving process, systems, and quality assurance mechanisms on electronic-claims This component will aim to improve quality of minimum data that is collected by PhilHealth through the claims managements system. Attention is required in the accurate and timely completion rate of the hospital claims forms, and in particular accurate filling of the ICD-10 codes. Outputs for 2  Formal definition of the PhilHealth dataset and its revision procedure is developed; (a) Official library of ICD 10 with ICD-10 (Philippines modification) and surgical procedures classifications developed  Coding standards for laboratory procedures and diagnostics, drugs and medicines, etc. to be reviewed and recommended to National eHealth Standards  Key datasets defined and approved by the National eHealth Standards;  Coding standards and procedures included in the standards catalogue of eHealth Standards and piloted in selected health care providers;  Capacity/capability of PhilHealth and hospitals relevant staff have been enhanced in data standards and data management;  The above outputs presented to the national eHealth Standardization Framework. Feb 14, 2018 Page 3 of 6 The World Bank Philippines Health Financing Strengthening Component 3: Supporting the hospital provider payment system reform The PhilHealth hospital payment reform is considering to improve transparency, efficiency and quality of hospital care, among others, to move to a diagnosis related grouping (DRG) based payment system, and when selecting the groupers, there is need to evaluate some possible groupers from other countries that may be relevant for the Philippines. Outputs for 3  Report and policy recommendation on the outcome/analysis of validation process on DRGs using selection criteria, and the results of simulation activity;  Updated tariff per group and expansion of existing groups; Public Disclosure Copy  Business requirements for DRG implementation identified and implemented, and Implementation strategy and design for DRG implementation developed;  Functional and technical specifications for the DRG Grouper software tool identified Component 4 – Project coordination and management The component will aim to support the management and regular reporting of the outputs of the project related activities. It will also include the technical and financial audits, procurement of goods and services, as per the small grant project governance requirement. It will include one technical lead recruited as individual consultant. Most other component consultants will be recruited through a firm. Both RETF and PhilHealth own resources will support this component. SAFEGUARDS D. Project location and salient physical characteristics relevant to the safeguard analysis (if known) Outputs of the grant will have nation-wide application, which includes indigenous communities. PhilHealth have existing program (i.e, The Indigent Program) that are specifically designed for vulnerable/marginalized groups such as IPs. Further, their membership profile includes data that allows them to identify and analyze vulnerable groups such as IP, women, poor and other marginalized groups. The PhilHealth also uses the results of the National Household Targeting for Poverty Reduction (NHTS-PR) of the Dept. of Social Welfare Feb 14, 2018 Page 4 of 6 The World Bank Philippines Health Financing Strengthening and Development which is the existing national targeting system for social protection, In the course of implementing the grant, Philhealth will ensure that the design and TORs for strengthening the databases and formulating the policies will be culturally- responsive to IPs, women and other marginalized groups. Moreover, they will also include special analytics on marginalized groups (including IPs) to find out how services could be improved for this sector, particularly in terms of reducing out-of-pocket cost. Lastly, the grant will ensure that representatives of IP groups will be included in all its consultations and policy dialogues from the start to completion. E. Borrower’s Institutional Capacity for Safeguard Policies PhilHealth has existing policies, programs and staff/units that purposely focuses on marginalized groups, including indigenous peoples, which were found adequate as platform for ensuring social safeguards related Public Disclosure Copy to IPs. This will be described in detail in the project document and PhilHealth has agreed to prepare a short framework/guidance note to ensure that IPs and other marginalized group are consulted and that their welfare will be of major consideration in preparing the design/TORs of the grant implementation. F. Environmental and Social Safeguards Specialists on the Team Maria Loreto Padua, Social Safeguards Specialist Maria Ayn Jella Villanueva Roxas, Environmental Safeguards Specialist G. Policies that might apply Safeguard Policies Triggered by the Project Triggered? Explanation (Optional) No civil works will be undertaken. This Environmental Assessment OP/BP 4.01 No policy is not triggered as impacts to environment are highly unlikely. This policy is not triggered as the grant will Natural Habitats OP/BP 4.04 No not impact natural habitats. This policy is not triggered given that the Forests OP/BP 4.36 No grant will not finance activities that affect forests. This policy is not triggered given that the Pest Management OP 4.09 No grant will not finance the purchase or use of pesticides. This policy is not triggered given that there Physical Cultural Resources OP/BP 4.11 No will be no expected impacts on physical cultural resources. Indigenous Peoples OP/BP 4.10 Yes Proposed grant will involve improving databases that will likely cover PhilHealth members from indigenous Feb 14, 2018 Page 5 of 6 The World Bank Philippines Health Financing Strengthening communities/groups. However, the expected impact of the grant on indigenous groups is positive in terms of improving the appropriateness of services and increasing health service utilization among marginalized groups, including IPs. Involuntary Resettlement OP/BP 4.12 No No civil works will be undertaken. This policy is not triggered given that the grant will not support the construction or Safety of Dams OP/BP 4.37 No rehabilitation of dams nor will support other investments which rely on the services of existing dams. This policy is not triggered given that the Projects on International Waterways OP/BP 7.50 No grant will not affect international Public Disclosure Copy waterways as defined under the policy. This policy is not triggered given that the Projects in Disputed Areas OP/BP 7.60 No grant will not affect disputed areas as defined under the policy. H. Safeguard Preparation Plan Appraisal stage ISDS required? No APPROVALS Team Leader(s): Karima Saleh Approved By Safeguards Advisor: Peter Leonard 21-Dec-2017 Practice Manager/Manager: David Wilson 21-Dec-2017 1Reminder: The Bank's Disclosure Policy requires that safeguard-related documents be disclosed before appraisal (i) by the Bank and (ii) in country by the Borrower/Recipient, at publicly accessible locations and in a form and language that are accessible to potentially affected persons. Feb 14, 2018 Page 6 of 6