DOH INITIAL INPUTS

DoH/LGUs conduct DoH reviews and revises LIPH

DoH/LGUs develop guidelines to include both
local needs Strategic Plan with population-based and
assessment each Integration Site individual-based services

DoH and Provinces/City Health Boards create Terms of

Partnership that includes identified assistance to
complement resources from DoH

DoH matches grants/intervention packages to LIPH

 DoH matches grants/intervention packages to LIPH

PhilHealth develop pric

references for drugs, dev
and prospective payment
services

DoH/PhilHealth support
Financing, Prospective

FINA
Payments

NCIAL
INTE
GRATI
ON
 DoH HRH Deployment
Programs and Augmentation

DoH Province-wide Health

System Governance Program

MAN
GERI
AL
INTE
GRATI PhilHealth Circulars on Heal

ON
Care Provider Network
standards and enumerated
catchment areas

DoH Communicatio
Programming
 DoH Communicatio
Programming

Health Facilities Deve

Program

TECH DoH Policies and Gui

SDNs

NICAL
INTE
GRATI
ON
INTE
GRATI
ON

DoH Interoperable
Information Systems

DoH Client Profile Li

profiling, NHTS of DS
PhilHealth datab
DoH Public Health Pr
AL INPUTS

revises LIPH Provincial/City Health Boards

nclude both DoH/CHD conduct
create LIPH that aligns with
ased and Strategic Plan and LIPH review and vetting of
ed services LIPH (with LGU)
guidelines

reate Terms of LGUs commit to provide funding from

ssistance to IRA
DoH

ages to LIPH
ages to LIPH

PhilHealth develop price

references for drugs, devices PSCO and PAGCOR channel funds to
and prospective payments for PhilHealth for patient premiums (after 2
services years)

PhilHealth develops guideli

linked to S

DoH/PhilHealth support on PHilHealth and DoH develop JMC with

Financing, Prospective DBM, COA and BIR on Global Budget
Payments

City Ordinance/Province SP
to create a separate depos
PhilHealth contracts Health Care Provider SHF
Networks

DoH and PhilHealth develop JMC with COA, C/PHB designate dedicated F
DoH, DBM and DILG on SHF the networ

C/PHB establish protocols, fo

for receipt and disbursem
providers

Provincial/City Health Boards

develop mechanisms to enforc
health care pricing and coverag
requirements

HHRDB develops integrated HRH

administrative standards
 HHRDB develops integrated HRH
administrative standards

DoH HRH Deployment LGUs, CHDs and Providers devel

rograms and Augmentation hiring incentives and recruit HR
HHRDB and LGUs conduct training needs
assessment

Health stakeholders form

expanded Provincial/City Healt
Boards (C/PHB )
DoH Province-wide Health
ystem Governance Program

C/PHO designs shared

management and administrativ
support systems

C/PHB work on eligibility requirements for

the Global Budget (enumerating catchment
areas, developing accounting tools)
PhilHealth Circulars on Health
Care Provider Network Providers make adjustments t
standards and enumerated meet standards as necessary
catchment areas
DoH develops Health Care Provider Network
and Primary Care Provider Network
certification standards

DPCB and PSCMT develop DPCB and PSCMT design poole

pooled procurement and procurement and logistics
logistics agreements management system

HCPN and C/PHB adapt UHC

DoH Communications DoH designs UHC Communications Plan Communications Plan to loca
Programming contexts

DoH Communications DoH designs UHC Communications Plan
Programming
Health technology
Health Facilities Development assessments accurately
Program capture each facility's
capacity and needs
C/PHO, with HFIDT, FICT,
HFDB, BLHSD and PhilHealth,
develop guidelines on
referral, navigation, patient
DoH Policies and Guidelines on assignment and working with
SDNs
private stakeholders under
integrated healthcare
delivery, including
enforcement mechanisms
HCPN and C/PHB adapt UHC
Communications Plan to loca
contexts
HCPN implements app
improvements to health
according to health tec
assessment recommen
C/PHO, PHB/CHB and other
LGU stakeholders develop
local policies on referral,
navigation, patient
assignment and working
with private stakeholders
under integrated healthcare
delivery, including
enforcement mechanisms
 LGU stakeholders build buy-
in for new integrated
approach to health care
delivery

DoH develops Scorecards for

Performance Governance System

DoH develops protocols for M&E,

including Clinical Practice Guidelines

DoH and PhilHealth develop data

DoH Interoperable Health standards and policies for Electronic
Information Systems support Medical Records (EMR) as part of the HIS

DoH and PhilHealth develop data

standards and policies on the DoH and Philhealth
Interoperable Health Information certification for
System (HIS) private Health Car
DoH Client Profile Lists (SDN
profiling, NHTS of DSWD, and
PhilHealth database)

DoH and PhilHealth design and build the

IT infrastructure for an Interoperable
Health Information System (HIS) that
facilitates data sharing and exchange
 IT infrastructure for an Interoperable
Health Information System (HIS) that
facilitates data sharing and exchange
DoH develops guidelines for disease
surveillance systems
DoH designs guidelines for public health
campaigns on health literacy, health-
DoH Public Health Programs
seeking behavior and population based
services
HEMB develops DRRH policies, guidelines
and protocols on governance, leadership,
capacity building, resource mobilization,
information and knowledge management
C/PHOs develop local d
systems to capture trends
of dise
LGUs carry out local public
health literacy, health-se
population bas
HEMB and LGUs implem
guidelines and protoco
leadership, capacity b
mobilization, informati
managem
Universal Health Care Integration
Theory of Change
 PhilHealth develops guidelines for Global Budget PhilHealth calculates Global Budget in PhilHealth rele
linked to SHFs accordance with guidelines tranch

City Ordinance/Province SP create resolution C/PHB develop separate book of accounts

to create a separate depository account for and use separate depository bank account
SHF for SHF

C/PHB designate dedicated Finance Director of Finance Director develops standard C/PHB submi
the network accounting processes financing and

/PHB establish protocols, forms and processes

for receipt and disbursement of funds to C/PHB develop auditable financing and
providers accounting database

rovincial/City Health Boards

velop mechanisms to enforce
alth care pricing and coverage
requirements
s, CHDs and Providers develop
ng incentives and recruit HRH
Health stakeholders form
anded Provincial/City Health
Boards (C/PHB )
C/PHO designs shared
nagement and administrative
support systems
oviders make adjustments to
meet standards as necessary
CB and PSCMT design pooled
procurement and logistics
management system
HCPN and C/PHB adapt UHC
ommunications Plan to local
contexts
LGUs, HHRDB and Providers hire
and train sufficient HRH
Providers create performance-
based incentives for HRH as
necessary
Providers operationalize shared
C/PHB adopts shared management
and administrative support systems management and administrative
support systems
DoH certifies and PhilHealth
accredits Providers
C/PHO adapts pooled procurement Supply officers oversee effectiv
and logistics management system pooled procurement and logisti
to local context management system
ODA, NGOs, PCSO and PAGCOR
provide assistance for first two ye
(such as commodities and suppli
HPCN, C/PHB and LGUs implement to complement resources from D
communications campaigns to educate
people about UHC

HCPN and C/PHB adapt UHC
ommunications Plan to local
contexts
HPCN, C/PHB and LGUs implement
communications campaigns to educate
people about UHC
ODA, NGOs, PCSO and PAGCOR
provide assistance for first two ye
(such as commodities and suppli
to complement resources from D

HCPN implements appropriate Each Provider's administration

improvements to health facilities maintains facility's functionality and
according to health technology quality through maintenance, and
assessment recommendations regular quality checks

HFCP offers acce

transportation
patients to rec
ne
HCPN and C/PHB run
communications campaigns to
inform patients about how to be
assigned and access their PCPs and
how to navigate HCPN
Patients know
and unders
how/when t
and/or publi

and other Province/City-wide Health

rs develop Authority matches patients to
n referral, Primary Care Providers and
patient patients are enrolled by Providers cl
d working PhilHealth packages/servic
keholders their own roles
healthcare service capa
luding n
echanisms C/PHO runs communications
campaigns to inform providers about
the new policies and systems
 DoH develops quality
management system standards C/PHB develop quality management
and incentivization mechanisms systems
for Providers
Providers are t
manage

DoH departments, providers and LGU

stakeholders familiarize with
Performance Governance System
reporting tools

C/PHO, PDOHO, PHST conduct M&E

C/PHO create city/province-level M&E of health care delivery including
plan Health Impact Assessments

Providers train IT personnel to

DoH and Philhealth develop HIS
certification for public and
private Health Care Providers
oversee operations of new HIS
C/PHO design and
conduct needs
assessment of Providers'
existing data systems
Providers adapt existing data
systems to comply with HIS
requirements
 C/PHOs develop local disease surveillance
systems to capture trends and predict outbreaks
of disease

People engage with public health People understand a

LGUs carry out local public health campaigns on campaigns on health literacy,
health literacy, health-seeking behavior and recommendations
health-seeking behavior and public health
population based services population based services

HEMB and LGUs implement DRRH policies,

guidelines and protocols on governance, City/Province leaders are trained to Cities/Province
leadership, capacity building, resource respond to health/medical needs in respond to health
mobilization, information and knowledge case of a natural disaster of a na
management
tegration Sites Program
f Change
PhilHealth releases Global Budget in
tranches to the SHF

C/PHB effectively consolidate funds to SHF

C/PHB, through the Treasury and

C/PHB submit all financial data to Accounting offices, comply with
financing and accounting database financial and accounting protocls

SHF effectively disburses funds to

providers and suppliers

Providers comply with reimbursement

requirements and processes
viders operationalize shared Providers within a C/PWHS have
agement and administrative functional management and
support systems administrative support systems

ply officers oversee effective Providers adopt pooled Providers within a C/PWHS have
led procurement and logistics procurement and logistics adequate medical supplies and
management system management system stocks

A, NGOs, PCSO and PAGCOR

de assistance for first two years
as commodities and supplies)
mplement resources from DOH
 A, NGOs, PCSO and PAGCOR
de assistance for first two years
as commodities and supplies)
mplement resources from DOH

Facilities are functional and sufficiently

equipped with back-up systems

HFCP offers accessible and affordable

transportation options for far-away
patients to receive medical care as
necessary
Patients see the right doctor at the right
time (whether public, private, PCP, or
specialists)

Patients know who their PCPs are, Patients go to PCP first when they
and understand and follow are sick
how/when to access their PCP
and/or public/private services

Patients receive appropriate referrals

Providers clearly understand
packages/service that they can offer,
their own roles and responsibilites,
service capability, and referral
norms
Patients see specialists as needed

Providers follow PCP, referral, and

navigation norms
 Providers follow PCP, referral, and
navigation norms

Providers are trained to use quality Providers use quality management

management systems systems

DoH departments, providers and LGU

stakeholders report on standardized
performance indicators

M&E reports and Health Impact

Assessments are published internally
by C/PHB

rsonnel to Providers at all levels submit EMR in the

f new HIS interoperable HIS
PhilHealth issues complying
Providers with HIS
certification

Providers at all levels submit facility-

level health data in the interoperable
HIS
 Disease surveillance system
accurately captures trends and
predicts outbreaks of disease in each
province or city.

People understand and agree with the People demonstrate health seeking
recommendations disseminated in behavior
public health campaigns

Cities/Provinces receive resources to City/Province DRRM efforts are

respond to health/medical needs in case coordinated with regional and
of a natural disaster national efforts
 FINANCIAL PATIENT OUTCOMES
INTEGRATION OUTCOMES

onsolidate funds to SHF

Providers and suppliers are
sufficiently reimbursed for
provision of services and medical
supplies in a timely and equitable
manner

Patients receive free basic health

care (zero co-pay) or are subject
to regulated co-pay ceilings
where relevant

y disburses funds to
s and suppliers

Providers consistently adhere to

regulated pricing and coverage
requirements

y with reimbursement
nts and processes

MANAGERIAL INTEGRATION PATIENT OUTCOMES

OUTCOMES
 MANAGERIAL INTEGRATION PATIENT OUTCOMES
OUTCOMES

HRH are sufficiently incentivized to

provide quality care

Patients have access to the health

personnel and services they need in
a timely manner
Health facilities and public health
campaigns have sufficient and
appropriately trained HRH

n a C/PWHS have Providers' management and

anagement and administrative teams ensure timely
support systems processing and delivery of health
care to patients

Patients have access to the

medicines and devices they need in
a timely manner

n a C/PWHS have Providers maintain sufficient

ical supplies and medical suplies and stocks
ocks overtime
 TECHNICAL PATIENT OUTCOMES
INTEGRATION OUTCOMES

Facilities support effective health

care delivery

Patients receive comprehensive,

high-quality, timely, and
affordable health and medical
services

Patients trust the HCPN in their

city or province
 HCPN offers comprehensive,
appropriate, effective medical and
health services to the entire
province/city

Quality management system and

M&E results are used by health care
leaders to improve processes and
quality

EMR are captured in a secure and

consistent manner and regularly
used by health personnel

Facility-level health data are captured

in a secure and consistent manner
and regularly used by health
personnel to improve health care
delivery
 HCPN adjusts resources (human,
pharmaceutical, etc.) to respond to
disease patterns or trends

Patients benefit from

comprehensive, responsive and
effective public health services to
the entire province/city

There is an appropriate burden of

disease on HCPN

The city or province can anticipate

and respond to health and medical
needs during natural disasters with
regional or national support as
necessary
 KEY

High risk pathway

Inputs
Processes (local)
Processes (national)
Outputs
Outcomes
UTCOMES

e free basic health

ay) or are subject
co-pay ceilings
relevant

UTCOMES
UTCOMES

ess to the health

ices they need in
manner

access to the
ices they need in
manner
T OUTCOMES

eive comprehensive,
ality, timely, and
health and medical
services

st the HCPN in their

or province
 ents benefit from
ensive, responsive and
public health services to
ntire province/city
DoH Department of Health
LGU Local government unit
LIPH Local investment plan for health
CHD Center for health development
IRA Internal Revenue Allotment
PSCO Philippine Charity Sweepstakes Office
PACGOR Philippine Amusement and Gaming Corporation
DBM Department of Budget and Management
COA Commission on Audit
BIR Bureau of Internal Revenue
JMC Joint Memorandum Circular
DILG Department of Interior and Local Government
SHF Special Health Fund
Province SP Province council
C/PHB City/Provincial Health Board
C/PHO City/Provincial Health Office
HRH Human resources for health
HHRDB Health Human Resource Development Bureau
P/CWHS Province/City wide Health System
DPCB Disease Prevention and Control Bureau
PSCMT Procurement and Supply Chain Management Team
HCPN Health Care Provider Network
ODA Overseas Development Assistance
PCP Primary Care Provider
HFIDT Health Facilities and Infrastructure Development Team
PHFDB Provincial Health Facilitiaties Development Bureau
FICT Field Implementation Coordination Team
HFDB Health Facilities Development Bureau
BLHSD Bureau of Local Health Systems Development
PDOHO Provincial DOH Office
HEMB Health Emergency Management Bureau
DRRH Disaster Risk Reduction Management
PHST Public Health Services Team