Home health care is an umbrella term for home-based initiatives helping individuals manage conditions ranging from hypertension to physical injuries, and its importance has grown as the global market, estimated at $167.28 billion in 2020, is projected to grow 8.65% annually over the next decade. A new rapid policy review published in npj Health Systems examines how the Philippines, as an exemplar lower-middle-income country, compares to seven other jurisdictions in addressing this growing policy gap.
Why This Home Health Care Policy Gap Study Matters
The global share of the aging population living in lower- and middle-income countries is expected to reach 80% by 2030, yet in 2013, 75% of LMICs had insufficient data to inform planning of health and social care for older populations. The Philippines faces a double challenge: a fragmented health care system mixing publicly funded and private for-profit providers with no effective regulatory mechanisms, and a substantially underdeveloped home health care sector with low awareness among legislators and regulators.
What the Current Philippine Regulatory Framework Covers
Beyond provisions concerning electronic health records in the 2019 Universal Health Care Act, the Philippines’ regulatory framework for home health care, telemedicine, and e-Health remains limited. Because the law’s implementing rules don’t explicitly cover home health care, PhilHealth does not provide coverage for existing local providers, meaning patients bear these costs out of pocket, with the impact falling disproportionately on lower-income households lacking private insurance.
How This Home Health Care Policy Gap Study Was Conducted
Researchers analyzed 118 Philippine-focused articles and 274 works from Australia, Canada, the European Union, Malaysia, Thailand, the United Kingdom, and the United States, using the Policy Analysis Triangle framework to examine context, content, actors, and process across each jurisdiction’s policies.
Key Differences in Workforce Coverage
Philippine literature identified specialized consultation providers like neurosurgeons, neurologists, sonologists, and ophthalmologists largely absent from other countries’ literature, but offered less coverage of ancillary and long-term care providers. Notably, informal caregivers, family caregivers, and independent or agency-based caregivers, extensively discussed in international literature, receive no mention in Philippine sources, suggesting a significant gap in research and policy recognition of their role.
What Global Best Practices Reveal Within This Home Health Care Policy Gap Analysis
International literature showed strong association between home health care and elderly, end-stage medical condition, and vulnerable populations, with emphasis on national, framework-based regulation and financing regimes. Four European jurisdictions, Germany, Sweden, Scotland, and the Netherlands, were specifically cited as examples of national frameworks for regulating and financing home care services.
Payment Model Comparisons
PhilHealth currently provides limited coverage through capitation-based payment tied to provider performance, differing from the fee-for-service and value-based purchasing models used in the U.S., and the lump-sum payments qualified patients receive in Ontario, Canada, and the U.K. Each payment model carries distinct tradeoffs that Philippine government agencies could evaluate when considering modifications to PhilHealth’s funding structure.
The Legislative Roadmap Within This Home Health Care Policy Gap Study
Given the Philippines’ presidential system, with single six-year terms and three-year congressional terms that disrupt policy continuity, researchers propose a heavily legislative-oriented, staged approach. In the short term, achievable within a single three-year legislative term, policymakers should formulate mutually agreed-upon definitions of home health care, telemedicine, telehealth, and e-Health, and convene a multi-sectoral core group to draft a codifying “Magna Carta for HHC.”
Medium- and Long-Term Proposals
In the medium term, within a six-year presidential term, the President would need to certify the codifying bill as urgent to fast-track it through Congress before a potentially less receptive administration takes over. Long-term proposals, focused on policy continuity across administrations, are considered less feasible given the Philippines’ appointive government agency leadership structure and the political sensitivity of constitutional amendments.
What This Home Health Care Policy Gap Study Means Going Forward
Given the researchers’ finding that low- and middle-income countries share LMICs’ typical challenges around infrastructure, technology, and policy and financial assistance, while high-income countries face rapid technology adoption requiring policies that keep pace with innovation, the Philippines’ proposed roadmap may offer a template for other LMICs navigating similar home health care policy gaps. Given the explicit call to integrate informal and family caregivers into formal policy frameworks, health authorities considering this recommendation may need to develop training and certification pathways specifically designed for caregivers currently operating entirely outside existing regulatory structures.
What to Watch Going Forward
As policymakers consider this study’s proposed legislative timeline, industry and public health observers will likely watch whether the short-term consensus-building and codifying law drafting proceeds within the current administration’s window, given the researchers’ explicit warning about the risks of policy discontinuity across presidential transitions. Given the study’s connection to broader ASEAN and WHO digital health strategy goals, this home health care policy gap research may also inform regional collaboration efforts as neighboring Southeast Asian countries navigate similar demographic and regulatory challenges in building out their own home health care infrastructure.
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