‘PhilHealth funds robust, substantial’

By Sheila Crisostomo (The Philippine Star), March 13, 2016

MANILA, Philippines – The Philippine Health Insurance Corp. (PhilHealth) yesterday assured the public that the agency’s finances remain stable and reforms are in place to ensure fund sustainability.

PhilHealth president and chief executive officer Alexander Padilla said that because their fund is robust and substantial, they were able to pay claims amounting some P34 billion in 2011, P44 billion in 2012, P55 billion in 2013, P77 billion in 2014 and P97 billion in 2015.

He noted that while PhilHealth’s premiums collections in 2015 amounted to P96 billion, they gained some P7 billion from investment income last year.

Aside from this, the agency’s reserve funds have also been growing steadily, from P112 billion in 2012 to P128 billion in 2015.

“To date, the National Health Insurance Program has provided coverage to 93 million members and dependents, representing 92 percent of the projected population of about 101 million,” he added.

Padilla said there is still “a need to improve the consistency of payments by the different member-sectors” despite the P95 billion premium collections last year.

“Collections had increased starting in 2013, when the national government started paying the premiums of poor Filipinos under the National Household Targeting system as a result of additional revenues from sin taxes,” he added.

The official, however, acknowledged that PhilHealth needs to continuously look at ways to improve operational efficiencies in collection, claims processing and benefit development.

To do this, PhilHealth has developed a strategic operational analysis and reporting tool that provides real-time information on membership coverage, claims and collections.

The agency had also enhanced its information technology systems, introduced steps to ease member registration and employer remittance processes and espoused anti-red tape initiatives, particularly in the frontline offices.

PhilHealth also strengthened its fraud prevention and control mechanisms like filing the appropriate cases, imposing fines and penalties on erring health care professionals and institutions to protect the health insurance funds.

Padilla appealed to the “sense of social solidarity from members who earn more” and to companies to regularly remit the proper premiums.

He said the Philippines has the lowest social health insurance premium rates in Asia.

The last time the rates were increased, particularly in the employed sector, was two years ago.

“Despite the status quo in premium contribution rates, PhilHealth expanded its case rates to cover over 4,000 medical conditions and surgical procedures, and introduced at least 13 Z Benefit Packages to provide financial risk protection for members coping with illnesses requiring prolonged treatment and management,” Padilla added.