Digitization among priorities of new PhilHealth chief
Metro Manila, Philippines - Dr. Edwin Mercado, the new president and chief executive officer of the Philippine Health Insurance Corp. (PhilHealth), will be pushing for digitization as among what he said are “remedies” for treating the “illnesses” of the government health insurer.
In a Malacañang briefing on Thursday, Feb. 6, President Ferdinand Marcos Jr. said Mercado promised to give a “more detailed” report on what could be changed or expanded in PhilHealth, after their “long talk” when they conducted the oath-taking ceremony.
“Kasi maganda naman ang serbisyo ng PhilHealth ngunit iyong pag-process ng claim, pag-apply, etc., kinakamay pa rin kaya’t napakabagal [PhilHealth services are good but the processing of claims, application, etc., are still done by hand that’s why they’re slow]. That's why it became a priority,” Marcos said, adding that the new PhilHealth chief has “many ideas” to make services “more inclusive.”
In his first working day, Mercado faced Malacañang reporters on Wednesday to outline his priorities.
“So ako bilang manggagamot, parang tinitingnan ko rin ang PhilHealth na may sakit, at inaalam ko rin ano ‘yung lunas,” Mercado said, adding he received orders for continued services and expanded benefits.
[Translation: As a health practitioner, I see PhilHealth as sick and I’m looking for a cure.]
Mercado said he is reviewing inefficient processes, such as the lack of standardized financial reports, as he saw potential “wastage” of funds that could be used to expand benefit packages.
“Kasi pag naipasatupad namin ‘yung digitization, magagawa rin natin na ‘yung mga claims ay mapa-flag din ‘yung mga claims na maaaring sumosobra o ‘yung maaaring kung tawagin ay may halong katakataka,” he said.
[Translation: When we digitize, we can also flag claims that are excessive or strange.]
He said he wants to look into the reasons behind “return-to-hospital” claims and slow claims processing, as well as updating the membership portal.
Marcos on Tuesday appointed Mercado, a US-trained orthopedic surgeon with extensive experience in hospital management.
In a statement, the Department of Health said Health Secretary Ted Herbosa, who chairs the PhilHealth board, met Mercado Thursday to discuss possible reforms.
Ledesma’s resignation
Mercado replaced Emmanuel Ledesma Jr., who quit the post, Marcos said. Ledesma was appointed in July 2023, after serving in an acting capacity since November 2022.
“Hindi siya sanay sa politika, eh [He’s not used to politics],” Marcos said of Ledesma’s resignation. “Manny Ledesma… comes from the private sector. So I think he found the transition to be jarring, shall we say.”
Mercado inherited issues surrounding PhilHealth, including the fund transfer to the national treasury and zero subsidy this year.
He said he would abide by the Supreme Court ruling regarding the controversial transfer of nearly P90 billion in surplus funds to state coffers for unprogrammed budget items. The high court has begun oral arguments on the petition against the transfer.
