Manila: The Philippine Health Insurance Corporation (PhilHealth) is realigning its strategy towards "smarter spending" to secure the long-term financial viability of the Universal Health Care (UHC) law while expanding benefit packages for Filipinos.
According to Philippines News Agency, during a forum at Healthway Cancer Care Hospital, PhilHealth President and Chief Executive Officer Dr. Edwin Mercado stressed the importance of viewing healthcare investments as catalysts for national development. He highlighted that a healthier population leads to a more productive workforce and stronger communities. This strategic shift is part of PhilHealth's commitment to supporting the UHC Law through immediate eligibility and expanded benefit packages.
Dr. Mercado noted that PhilHealth has efficiently reduced its claims payment turnaround time from up to 60 days to just 10 to 11 days despite managing a larger volume of requests. This improvement is attributed to digital upgrades that minimize paperwork errors and reduce rejected claims. PhilHealth is also leveraging data to broaden its coverage under the UHC law, with a focus on primary care through the YAKAP (Yaman ng Kalusugan Program), alongside addressing costly medical needs like dialysis, cancer treatments, and maternity care.
To make healthcare costs more predictable for patients, PhilHealth is experimenting with global budgets and clearer co-pay systems, providing doctors and facilities with more financial certainty. From January 1 to May 8 of this year, PhilHealth paid out 152 billion pesos, with projections suggesting an annual total of 400 billion pesos. Of this amount, 60 percent, or 91.3 billion pesos, are directed towards indirect members, while 16.9 million pesos cater to direct contributors.
As medical expenses continue to rise, Dr. Mercado emphasized the necessity of investing in preventive public health and increasing government subsidies to maintain the program's seamless operation. The call for PhilHealth's fiscal resilience was echoed by Dr. Valerie Gilbert Ulep of the Philippine Institute for Development Studies, who highlighted the importance of balancing broader access with sound fiscal planning to sustain public trust in the state insurance fund.
Healthcare leaders and development partners at the forum underscored the need for responsive financing mechanisms and robust public-private collaborations to prevent institutional strain. Private Sector Advisory Council Health Sector lead Paolo Borromeo stressed the importance of building a resilient system to support PhilHealth's long-term commitments, emphasizing shared responsibility across various sectors.
The forum concluded with a consensus on the necessity of strengthening PhilHealth's institutional capacity, optimizing its spending strategies, and expanding infrastructure to sustain the momentum of the country's health insurance reforms.
