.png){kind=logo}
1 week ago
10
Upgrade to High-Speed Internet for only ₱1499/month!
Enjoy up to 100 Mbps fiber broadband, perfect for browsing, streaming, and gaming.
Visit Suniway.ph to learn
Marco Luis Beech - The Philippine Star
January 8, 2026 | 12:00am
In a briefing with reporters, PhilHealth president and CEO Edwin Mercado reported that the agency’s benefit payments reached P289.26 billion as of December 2025, a 76 percent increase from the P164.32 billion recorded in 2024.
Businessworld / File
MANILA, Philippines — The state-run Philippine Health Insurance Corp. (PhilHealth) reported a significant surge in its benefit payments, underscoring a substantial expansion in the state health insurer’s financial support and assistance to its members compared to 2024.
In a briefing with reporters, PhilHealth president and CEO Edwin Mercado reported that the agency’s benefit payments reached P289.26 billion as of December 2025, a 76 percent increase from the P164.32 billion recorded in 2024.
“The question is, is this enough? Clearly, it’s not enough. We still have a long way to go. We need greater coverage, not just in terms of cost, but also in terms of access points,” Mercado said.
He added that the agency has identified the health care needs of the public, noting that it studied members’ claims and prioritized so-called catastrophic conditions that can drain household incomes.
Mercado said PhilHealth is preparing to transition to a Diagnosis Related Group-based global payment system, a method that takes into account comorbidities and complications in determining reimbursements.
“This is the payment method that takes into account the comorbidities or complications of a disease. Now, when a diagnosis is given, we pay the same amount based on the diagnosis alone. It is not based on whether it has corresponding diabetes, hypertension, or other complications,” he said.
Mercado added that the agency has deployed “boots on the ground” personnel to conduct thorough assessments of hospitals and clinics, particularly under the Yaman ng Kalusugan Program.
The initiative, approved by the PhilHealth board, includes additional staff to support implementation and the rollout is now being carried out end-to-end.
The PhilHealth chief added that they have also strengthened their internal capacity by collaborating with experts and representatives of their members, engaging in discussions with various patient groups to better address their needs.
