Background. PhilHealth’s Konsulta Program has provided financing for outpatient primary care services in the decentralized Philippine health system since 2021. However, despite a record number of accreditations nationwide, many accredited facilities struggle with their institutionalization and operationalization, as evidenced by PhilHealth’s extremely low capitation disbursements. This study examines and identifies the critical drivers of Konsulta implementation in the Batuan Primary Care Facility (PCF), a local government unit (LGU)-owned rural health facility in the fourth-class municipality of Batuan, within the province of Bohol, which generated an aggregate 10.35 million Philippine pesos (Php) alongside significant growth in patient and service coverage.
Methods. A sequential mixed-methods case study design was employed, combining quantitative analysis of secondary financial and service data (2022-2025 PhilHealth Statement of Accounts Payable; Batuan LGU financials) with qualitative thematic narrative analysis drawn from document reviews (AKSK project report, LGU ordinances, and meeting minutes) and semi-structured key informant interviews with PCF staff, LGU officials and national agency representatives. Descriptive statistics assessed performance while thematic analysis ranked drivers.
Results. Batuan generated Php 10.35 million from Konsulta which increased 2023 LGU health funds and compensated 2024 and 2025 budget cuts. Four initial institutionalization constraints emerged 1) governance, 2) health resources, 3) human workforce, and 4) information technology systems, which were addressed by the implementation AKSK project. Critical drivers ranked by salience included 1) strong governance, 2) health workers' commitment, 3) external agency collaboration and 4) community participation.
Conclusion. Batuan’s implementation demonstrates Konsulta’s viability in improving primary care financing. Critical to its success are robust government support, strategic partnerships, driven workforce, and active community engagement. Despite implementation challenges, policy reforms, service enhancement and capability investments enabled Batuan to create a replicable model for other local government units.
