IMPLEMENTATION AND OUTCOMES OF ZERO-BILLING POLICIES IN PUBLIC HOSPITALS: MEDICAL PERSONNEL'S PERSPECTIVE

This study examines the implementation and outcomes of the Zero-Billing Policy in public hospitals from the
perspective of medical staff to assess its impact on Universal Health Care (UHC). A systematic review of
institutional reports, government documents, and peer-reviewed literature was conducted in accordance with
the PRISMA 2020 guidelines, guided by the CIPP evaluation model, with a focus on financial protection
reforms and no-balance-billing schemes, and 50 of the 74 relevant publications that were examined using the
PRISMA approach were kept, while 24 were eliminated. The policy is presented as a redistributive mechanism
with the goal of eliminating out-of-pocket expenditures, and it is based on UHC literature and Republic Act
No. 11223. Medical staff report increasing workloads, staffing and supply restrictions, payment delays, and
administrative difficulties that compromise service quality and sustainability, despite viewing zero-billing as
ethically just and equity-enhancing. The results reveal ongoing gaps between policy objectives and accessible
inputs and procedures when viewed through the CIPP lens. According to the study's findings, the sustainability
and efficacy of the Zero-Billing Policy depend on stable funding, enhanced health system capacity, significant
frontline involvement in policy creation, and formalized feedback mechanisms to safeguard the welfare of both
patients and employees.