New era dawns for PhilHealth

State health service enabler Philippine Health Insurance Corp. (PhilHealth) aims to further lower the out-of-pocket medical costs for patients to 25 percent from the current 45 to 47 percent under the leadership of Edwin Mercado, its new president and chief executive officer.

Mercado holds it is important to obtain correct and relevant data that will be used as the basis for future benefit enhancements.

“We are adhering to the directive of our esteemed President Ferdinand ‘Bongbong’ Marcos Jr., ensuring the continuity of our services and further expanding the benefits,” he said.

Mercado said he would prioritize computerization and digitalization using modern technologies to enhance member experience, strong engagement with stakeholders, and improvement of operational processes.

PhilHealth since the start of the year has been implementing its P284 billion Corporate Operating Budget, according to the Department of Health (DoH).

Last year, Health Secretary Ted Herbosa said the state-run insurer has a P150-billion surplus from its 2024 budget to cover the indirect members’ subsidy.

On 4 February, President Ferdinand R. Marcos Jr. appointed United States (US)-trained orthopedic surgeon Dr. Edwin Mercado to head PhilHealth.

Mercado has 35 years of experience in hospital management and has been the vice chairperson of the Mercado General Hospital/Qualimed Health Network since March 2021.

According to Marcos, Mercado “has demonstrated proven leadership and executive and strategic planning expertise.”

Under his leadership, Mercado General Hospital Inc. has expanded into a national chain of healthcare facilities that include four general hospitals, six multi-specialty clinics, two surgery centers, 150 primary care corporate clinics, a college for paramedical professionals, and a physician practice group of 400 four doctors.

A Doctor of Medicine graduate of the University of the Philippines in 1987, Mercado completed his Master of Medical Sciences in Global Health Delivery from Harvard Medical School in 2023.

He also has an Executive Master’s in Healthcare Administration from the University of North Carolina in the US.

Mercado has dedicated his work to ensuring equitable access to quality medical care and leveraging technology to strengthen health systems, particularly in financial management and primary care programs.

He did advocacy work with the Zuellig Family Foundation and several DoH Centers for Health Development, providing technical assistance to Provincial Health Boards on operationalizing their Healthcare Provider Network.

Mercado also serves as a faculty lecturer at the Ateneo School of Medicine and Public Health on Global Supply Chain, Research Methods, and Implementation Science, and a guest lecturer at the University of the Philippines College of Public Health on Medical Processes and Programs.

Further, he is involved in an ongoing study on using Artificial Intelligence (AI) as an assistive tool for community health workers to deliver primary care.

Added benefits

Among the things to look forward to during Mercado’s leadership, is his promise for additional benefits for PhilHealth members using the P29.9 billion worth of excess funds.

“The first thing that we outlined is the additional benefits and how much funds need to be allocated so we have a study to intensify our actuary, the first is the contributions, premium contributions of our direct members,” Mercado said during a recent Senate Committee on Health and Demography’s hearing.