'The more you compromise, the more you fall into a hole'

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Posted: 5:32 AM | Apr. 30, 2006

Inquirer

Published on page B3 of the April 30, 2006 issue of the Philippine Daily Inquirer

THE country's Health Maintenance Organization (HMO) industry faces a problem—it has no image, at least not the kind it deserves to have.

There is very scant information on how it works.

To a lot of people, the HMO industry has become more of a commercial enterprise instead of one aimed at providing health care.

The Health Maintenance Organization Act of 2004 states: an HMO is an "organized system of managing and assuring health care services in a defined geographical area; a pre-agreed set of basic and supplemental health maintenance and treatment services; and has an enrolled group of individuals paying a fixed periodic fee." Moreover, HMO, being a "Managed Care," as described by the similar bill, is "a system of health care delivery that influences utilization and cost of services and measures performance with a goal to deliver quality and cost-effective health care."

IntelliCare, an HMO that claims to be trying to do what the law asks for, has been in the business for 10 years now.

Why would the country's top corporations acquire their services? Human resource department heads, company presidents and other decision-makers first look at reputations when deciding on HMO companies. After all, having an HMO is now widely considered a crucial part in the maintenance of human resources.

IntelliCare claims it is ranked as one of the top three HMOs in the country.

The decision to establish an HMO had a lot to do with a calling. IntelliCare president, Mario Silos says, "You can make a lot of money out of other businesses that don't have real value to other people. But the founding group of this company wanted to make a difference, to be remembered that we had a contribution to society; that we affected people positively and in the process made a decent return to our stockholders."

It wasn't a yellow brick road at the start for IntelliCare. Like most businesses in Asia, they were challenged with the major financial debacle in 1997 when companies faced restructuring, downsizing and even closure.

The economic landscape was in bad shape. IntelliCare stuck by the value of its rates or premiums pre-meltdown. They did not succumb to the market penetration strategy that in order to gain ground, one must be prepared to lose first. The result? They grew at 30 percent per annum consistently.

They did not compromise on the basis of their actuarial assumptions or on the basis of service excellence. "The more you compromise, the more you fall into a hole," Silos asserts. They were a toddler by industry standards and thus hard-put to build a reputation. Anyone knows one doesn't build a good business reputation overnight. It usually takes a remarkable amount of effort, hard work and perseverance.

They did not go for big name clients at once. It was hard, after all.

In its younger days, in-house sales were more significant than broker-generated sales. But IntelliCare eventually turned the tide. Past the economic meltdown and growing consistently, brokers started to bring in companies such as Dell, Coca-Cola and other major accounts for bidding.

The company realizes that the initial 10 years was just spent to lay the foundation, to establish a reputation and surpass a critical mass base required for long-term stability. In the next 10 years the firm aims to achieve market leadership both in quantity and quality of service.

And the company knows they have to innovate to continue into the next decade.

They are now looking into tapping new markets, those which do not yet have the comfort and convenience of having their own HMO to give them the security of health because of financial limitations.

In the future, the company wants to serve the millions in the nation's workforce. IntelliCare knows that the concept of the HMO has not yet fully developed and that it still has more than enough room for growth. Health care after all, is a function of demography and the Filipino population is definitely maturing.

One of its notable innovations is the recently launched Pamilya Care program designed for OFWs and the families they leave behind here.

Silos asserts that HMOs should be a bridge to a point where health services should be accessible and affordable to all.

But it has to be a bridge that is sturdy.