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Thursday, April 18, 2024

PhilHealth ready for Health Care challenge

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The Philippine Health Insurance Corp. on Monday said it was ready to take on the challenges of Universal Health Care which President Rodrigo R. Duterte will soon sign into law after it posted stronger performance in 2018.

PhilHealth Acting president and CEO Dr. Roy B. Ferrer said such performance was enough proof that the National Health Insurance Fund was intact and protected to meet the rising health care demand of its 100-million beneficiaries here and abroad.

“As stewards of the National Health Insurance Fund, we owe it to the members and stakeholders to keep their fund in excellent shape to meet all our financial obligations,” stressed Ferrer.

PhilHealth records showed that it surpassed its previous year’s records on its net income, benefit payments and membership coverage.

In its November-end financial status, PhilHealth got a net income of P8 billion which is 671 percent higher than last year’s P1 billion, a virtual seven-fold growth. 

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With just a month left before the year comes to a close, PhilHealth expressed optimism that it will end the year with a positive bottom line. 

Owing to its intensified collection activities, the state agency registered a premium income of P118 billion or 21 percent higher than last year’s P97.180 billion. Releases by the National Government for the premium contributions of around 21-million indigent and senior citizen members and their qualified dependents topped the billing at P49.7 billion which is 15 percent higher against P43 billion from the same 11-month period last year. 

Coming in next are the premiums paid on behalf of private-sector workers at P43.6 billion, having the highest year-on-year growth with 34 percent or P11-billion increase from last year’s P32.5 billion.  

Meanwhile, its investment portfolio rose to P152 billion which is 21 percent higher than last year’s level.

In benefit payments, PhilHealth released P111 billion, 15 percent higher than last year’s P96 billion, paying its health care providers at an average of P3 billion a week.

Some 26 percent of its total benefit payouts, amounting to P29 billion, were availed of by senior citizens and lifetime members. Close on their heels the indigent members and their dependents who were paid P28 billion. 

Interestingly, they comprise 25 percent of claims payouts, aside from having the highest year-on-year growth at 62 percent. 

Ferrer pointed out that the increasing amount of claims payments is a result of PhilHealth’s aggressive educational campaign on PhilHealth benefits and entitlements, and how to effectively avail of them. Among these information drives include the ‘PhilHealth Forward,’ ‘Project ReachOut,’ various stakeholders fora, and its signature ‘Alaga Ka,’ a grassroots level road show aimed at increasing awareness and appreciation of the National Health Insurance Program. These campaigns were mainly for PhilHealth marginalized members.

It declared that alongside its increasing benefits payouts is “the new speed with which claims are processed.” Good claims processing had taken only 22 days—which is 38 days faster than the 60 days provided for by law. Good claims refer to filed claims with complete documentary requirements. These do not include claims that are under investigation, return-to-hospital and those denied by its local health insurance offices. 

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