The Philippine Health Insurance Corporation or PhilHealth is expanding its technological, financial and human resources to improve medical aid to Filipinos.

PhilHealth president and chief executive officer Emmanuel R. Ledesma Jr. said the state insurer is enhancing its online portal to ease transactions of individual members and partnered hospitals as the government shifts to digital services.

“We are moving forward with digitalization. The Board approved already that we start e-money services,” he said last Thursday, 14 March, during the weekly Rotary Club of Manila meeting in Manila Polo Club, Makati City.

He said this decision was made on 13 March.

Ledesma said digitalization of PhilHealth supports the effectivity of the eGOV app, a mobile service that allows the public to easily register, pay and monitor transactions for various services from the government.

“With a touch of a button, you’ll be able to see your PhilHealth contributions, benefits and other transactions,” Ledesma explained.

He did not elaborate on the digital enhancements but said they will bring PhilHealth services much closer to members.

Patience

However, Ledesma asked the public to be more patient as PhilHealth is also looking for more employees to help provide services. “We’re going to get there, but it will take some time,” Ledesma said.

Currently, PhilHealth employs 7,000 people.

The Department of Information and Communications Technology Chief for E-Governance Mon Gutierrez had said the government is working double-time to activate up to 1,000 digital programs to 22 other government departments and 1,700 local government units.

PhilHealth is an agency of the Department of Health that provides 22 million Filipinos financial aid for medical consultations, treatments, laboratory tests and medicines.

More benefits coverage

Ledesma said PhilHealth has received funds amounting to P500 billion which it will be using to expand benefits coverage to 30 percent.

On 14 February, PhilHealth started implementing the higher coverage for nearly all health conditions. It said the increase was made to lighten the burden of patients from inflation.

The new rate for benefits coverage came after PhilHealth’s premium contribution requirement was raised from 4 percent to 5 percent and became effective starting 1 January.

As a result, Ledesma said PhilHealth funds for benefits packages will have an additional P35 billion.

PhilHealth also reported it has released over P257 million in advanced payments to its partner health providers of primary care under the Konsulta Package which provides PhilHealth members a range of services: consultations, screening, laboratory tests and delivery of medicines.

The first batch of Konsulta Package payments were directed to four out of the seven PhilHealth’s primary care providers that are participating in its sandbox. It is a testing method where an idea can be improved while eliminating financial and other risks.

The first recipients of the Konsulta package payments are located in Quezon Province with P72.9 million, South Cotabato (P53.9 million), Bataan (P114.7 million) and Baguio City (P15.9 million).

A funding of P30 billion was allocated to the Konsulta package this year, after the seven sandbox sites for primary care providers network were launched in June last year.

Konsulta

Konsulta already benefits 22 million Filipinos, PhilHealth senior vice president for Fund Management Renato Limsiaco Jr. said.

Ledesma said it is also collaborating with First Lady Liza Araneta-Marcos to expand her flagship project “Laboratoryo, Konsulta, at Gamot Para sa Lahat Caravan.”

This provides quicker health services that are similar with those under the Konsulta Package.

PhilHealth said some 14,000 Filipinos have benefited from 17 caravans held in various parts of Luzon and the National Capital Region as of 31 December 2023.

“We cannot expect people to go to clinics that are far from where they are because that means expenses for transportation and food,” Ledesma said.

Multiple fund sources

Ledesma assured hospitals that they will be given due payments for medical services rendered to PhilHealth members as its funds remain sufficient.

“The issue is not that PhilHealth lacks funds. There are always two sides of the coin. It is not always the fault of PhilHealth,” he said.

These statements came after Private Hospital Association of the Philippines Inc. president Dr. Jose Rene De Grano said on 15 February that some hospitals are still waiting for their receivables amounting to P7 billion.

Ledesma said PhilHealth continues to meet with hospitals’ managers to help improve or streamline each other’s data systems to reflect accurate amounts of receivables from the state insurer.

“On the other hand, there might be improper claims. The problem could be inefficient systems,” he said.

Ledesma said PhilHealth’s funds are sourced from multiple government agencies and corporations.

These include the allocation from the Department of Budget and Management, sin taxes collected by the Bureau of Internal Revenue, and revenue shares from the Philippine Charity Sweepstakes Office and the Philippine Amusement and Gaming Corporation.

Limsiaco said PhilHealth received P50 billion from sin taxes last year, and P61 million allocation from the national budget this year.

He also said PhilHealth distributed P3.5 billion to hospitals this week, increasing the P26 billion already given to hospitals from January to February.

Limsiaco said the fund releases so far represent over P6-billion increase from the level recorded last year.