PhilHealth raring to implement reforms; takes on the challenges of Universal Health Care




Philippine Health Insurance Corporation (PhilHealth) Acting President and CEO Dr. Roy B. Ferrer assured the Filipino public that the state-run agency is prepared for the imminent enactment of the Universal Health Care (UHC) bill.

“Our strong performance last year clearly displayed our capability to run the National Health Insurance Program (NHIP). In fact, our record-setting performance in 2018 is a perfect prelude to our transition to UHC,” said Ferrer, adding that, “We have categorically proved our ability to keep the [NHIP] fund robust, dynamic, and responsive to the medical needs of the Filipinos.”

Ferrer referred to the social health insurer’s successful financial turnaround last year that was highlighted by a staggering P11.6-B in net income, or 4400% higher compared to 2017 end.

Its premium income was recorded at P132.5-B which is 23% higher than that of 2017, stemming from enhanced collection measures. It also received a P6.8-B boost from investments and other income that further solidified its financial position. 

On the other side of its balance sheet, PhilHealth paid a total amount of P121-B in health care benefits, translating to payouts of an average of P3 billion a week starting the second half of 2018, proof that more than ever, more and more members and their families are utilizing their benefits for their hospitalization and treatment needs.

Meanwhile, its operating expenses remained controlled at P6.60-B which is one percent lower than last year’s P6.64-B, a strong indication of PhilHealth’s commitment to prudence and austerity without sacrificing its financial commitments to providers and quality of service as well. 

PhilHealth’s current investment portfolio and reserve funds stand at P149-B and P97-B, respectively; indicating that the National Health Insurance Fund is intact, protected and always ready to meet the rising health demands of its beneficiaries.
 
In terms of benefit enhancements, PhilHealth extended the provision of Primary Care Benefits to the Formal Sector, Lifetime members, and Senior Citizens. In addition, PhilHealth launched its new Z Benefit packages for children with disabilities, and increased its coverage for Newborn Care. The enhancements in benefits clearly manifested its dedication to innovation and in keeping its relevance to its beneficiaries.

However, the PhilHealth Chief stressed that to continue ensuring their robust financial position; it is incumbent that they intensify their efforts at controlling fraudulent and abusive practices of a few accredited health care providers and even members. 

“In response to the issues raised by Senate President Vicente Sotto III, we are in collaboration with the National Bureau of Investigation to investigate the fraudulent acts of a health care professional and at least three hospitals in the South. In fact, the Philippine Medical Association (PMA) and the Philippine Hospital Association (PHA) have also joined us in our crackdown on fraud,” Ferrer declared. The alliance was formed during the PhilHealth Forward event held as part of its anniversary celebration last February 14.

“This show of support could be a start of an effective anti-fraud cooperation that puts dishonest parties to justice. I am thankful of their [PMA and PHA] support and I hope that this continues in the future,” said Ferrer and warned that, “We will continue pursuing cases against entities committing fraud. We will not let their deceitful practices undermine the welfare of NHIP beneficiaries.”

To date, PhilHealth has filed a total of 298 cases against 71 hospitals, resulting in the suspension of accreditation of some 31 hospitals.

Finally, NHIP coverage jumped to 98% of the Philippine population translating to a total of 104.5 million out of the 2018 projected population of 106.4 million. PhilHealth reckoned the bill’s passage to be the deciding factor to finally cover the entire nation under the NHIP. “Once decisive push,” said Ferrer. “That’s all we need and that’s what this law will provide.”

Upon its enactment, the UHC mandates the inclusion of all Filipinos in the NHIP, and that no Filipino will be denied access to health care whenever they need them. PhilHealth even urged its members and stakeholders to involve themselves in discussions and activities that ultimately help UHC achieve its purpose. END


Reference: Shirley B. Domingo M.D., Vice President for Corporate Affairs and Official Spokesperson | Mobile No.: 0917-1360964

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