₱1-B DOH fund to extend Zero Balance Billing to LGU hospitals, including Mindanao facilities

MANILA (January 6) — The Department of Health has earmarked ₱1 billion to begin implementing zero balance billing (ZBB) in selected large hospitals operated by local government units (LGUs), a move expected to benefit indigent patients in Mindanao and other regions long burdened by out-of-pocket hospital costs.

In a statement Monday, the DOH said Ferdinand R. Marcos Jr. confirmed the allocation, which will be used to reduce patient charges for basic hospital accommodation to zero in participating LGU hospitals starting 2026.

The initiative expands ZBB beyond DOH-run hospitals, where it has been in place for years, to include LGU-managed facilities that meet technical and operational standards.

How Zero Balance Billing Works in Practice

Under zero balance billing, eligible patients are discharged without paying hospital bills for covered services.

In practice, this means:

No payment for basic room accommodation
No charges for professional fees of attending physicians
No billing for diagnostic tests, medicines, and procedures included in the ZBB package

Hospital costs are covered through a combination of PhilHealth reimbursements and government subsidies, eliminating the need for patients to seek financial assistance or political endorsements.

The DOH emphasized that, similar to ZBB in DOH hospitals, guarantee letters from politicians will not be required in LGU facilities participating in the program.

What This Means for Patients in Mindanao

For patients in Mindanao, where many large hospitals are LGU-run and households face higher poverty incidence, the policy could significantly reduce barriers to care.

In many provincial and city hospitals, families often leave facilities with unpaid balances, forcing them to borrow money, sell assets, or delay treatment.

“This is meant to stop the cycle where patients survive illness but leave the hospital in debt,” a DOH official said.

Once implemented, indigent and financially vulnerable patients admitted to qualified LGU hospitals in Mindanao could expect zero billing at discharge for covered services, provided they meet eligibility criteria.

Which LGU Hospitals Will Qualify

The DOH said LGU hospitals will be selected based on the maturity of their local health systems and readiness to sustain the program.

Criteria include:

Compliance with PhilHealth accreditation
Ability to meet reporting and auditing requirements
Operational capacity to deliver services without passing costs to patients

Only large LGU hospitals that meet these standards will be included in the initial rollout, with expansion planned once systems are stabilized.

Health officials noted that this approach aims to prevent program failure due to underfunding or weak hospital management.

Funding Release and Timeline

The ₱1-billion allocation will be released directly to qualified LGU hospitals, mirroring the funding mechanism used for DOH-run facilities.

However, the DOH said detailed guidelines will only be finalized once the department receives the official copy of the 2026 General Appropriations Act, which will define implementation rules, coverage scope, and monitoring mechanisms.

Addressing Long-Standing Gaps in LGU Hospitals

Health advocates in Mindanao say extending ZBB to LGU hospitals addresses a long-standing equity issue.

“Many patients live far from DOH hospitals,” said a public health worker in Northern Mindanao. “LGU hospitals are where most people actually go. That’s where zero billing is needed most.”

While the program will initially cover only selected facilities, the DOH said the long-term goal is to normalize zero balance billing across both national and local hospitals, reducing dependence on ad hoc assistance and charity-based care.

Reducing Out-of-Pocket Costs

The ZBB expansion is part of the administration’s broader push to cut out-of-pocket health spending, which remains among the highest in Southeast Asia.

For Mindanao patients, particularly those in rural and conflict-affected areas, officials say the policy could mean earlier treatment, fewer delayed admissions, and less financial strain on families already facing economic pressures.

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₱1-B DOH fund to extend Zero Balance Billing to LGU hospitals, including Mindanao facilities

In a statement Monday, the DOH said Ferdinand R. Marcos Jr. confirmed the allocation, which will be used to reduce patient charges for basic hospital accommodation to zero in participating LGU hospitals starting 2026.

The initiative expands ZBB beyond DOH-run hospitals, where it has been in place for years, to include LGU-managed facilities that meet technical and operational standards.

How Zero Balance Billing Works in Practice

Under zero balance billing, eligible patients are discharged without paying hospital bills for covered services.

In practice, this means:

Hospital costs are covered through a combination of PhilHealth reimbursements and government subsidies, eliminating the need for patients to seek financial assistance or political endorsements.

The DOH emphasized that, similar to ZBB in DOH hospitals, guarantee letters from politicians will not be required in LGU facilities participating in the program.

What This Means for Patients in Mindanao

For patients in Mindanao, where many large hospitals are LGU-run and households face higher poverty incidence, the policy could significantly reduce barriers to care.

In many provincial and city hospitals, families often leave facilities with unpaid balances, forcing them to borrow money, sell assets, or delay treatment.

“This is meant to stop the cycle where patients survive illness but leave the hospital in debt,” a DOH official said.

Once implemented, indigent and financially vulnerable patients admitted to qualified LGU hospitals in Mindanao could expect zero billing at discharge for covered services, provided they meet eligibility criteria.

Which LGU Hospitals Will Qualify

The DOH said LGU hospitals will be selected based on the maturity of their local health systems and readiness to sustain the program.

Criteria include:

Only large LGU hospitals that meet these standards will be included in the initial rollout, with expansion planned once systems are stabilized.

Health officials noted that this approach aims to prevent program failure due to underfunding or weak hospital management.

Funding Release and Timeline

The ₱1-billion allocation will be released directly to qualified LGU hospitals, mirroring the funding mechanism used for DOH-run facilities.

However, the DOH said detailed guidelines will only be finalized once the department receives the official copy of the 2026 General Appropriations Act, which will define implementation rules, coverage scope, and monitoring mechanisms.

Addressing Long-Standing Gaps in LGU Hospitals

Health advocates in Mindanao say extending ZBB to LGU hospitals addresses a long-standing equity issue.

“Many patients live far from DOH hospitals,” said a public health worker in Northern Mindanao. “LGU hospitals are where most people actually go. That’s where zero billing is needed most.”

While the program will initially cover only selected facilities, the DOH said the long-term goal is to normalize zero balance billing across both national and local hospitals, reducing dependence on ad hoc assistance and charity-based care.

Reducing Out-of-Pocket Costs

The ZBB expansion is part of the administration’s broader push to cut out-of-pocket health spending, which remains among the highest in Southeast Asia.

For Mindanao patients, particularly those in rural and conflict-affected areas, officials say the policy could mean earlier treatment, fewer delayed admissions, and less financial strain on families already facing economic pressures.

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