Newly appointed Philippine Health Insurance Corporation (PhilHealth) president and CEO Dr. Edwin Mercado vowed on Feb. 5, to overhaul the state-run health insurer with a data-driven approach aimed at standardizing financial reporting, digitizing systems, and plugging inefficiencies that drain resources.
He said such efforts would ultimately expand benefits and improve patient care.
“Una po ay titingnan natin iyong proseso na kung tawagin ay efficiency dahil mukhang sa ngayon po ay mayroon pa tayong puwedeng i-plug na mga leaks o iyong sinasabing wastage (First, we will examine the process, which we refer to as efficiency, because it seems that currently, there are still leaks or what we call wastage that we can plug),” Mercado said during a Malacañang press briefing.
Mercado also reiterated the administration’s commitment to data-driven decisions.
“Mayroon pong commitment na tingnan po muna iyong datos. So, kailangan po na data-driven iyong atin pong mga desisyon moving forward (There is a commitment to first review the data. So, our decisions moving forward must be data-driven),” he stated, emphasizing that updated and standardized financial data will be critical to defend future budgets and secure additional funding if necessary.
The new PhiHealth chief stressed that standardizing the financial reporting process is a priority.
“For example, ng pagri-recording po ng mga financial reports, isa-standardize po natin para kapag naglalabas ng regular na financial reports ay hindi po pabago-bago. Mahirap pong mag-analyze kapag ang financial reports ay iba ho iyong definition ( For example, in recording financial reports, we will standardize the process so that when regular financial reports are released, they are consistent. It is difficult to analyze data when the definitions of financial reports vary),” he elaborated.
When asked about the subsidy issues and the criticism of PhilHealth’s slow services, Mercado maintained that efficiency is key in serving the public.
“So, iyong kaakibat ng efficiency kasi kung anuman iyong makukuha natin from the wastage, iyon iyong gagamitin nating pagpalawig ng benepisyo (So, the efficiency aspect means that whatever we recover from wastage will be used to expand benefits,” he explained.
He also highlighted the planned computerization of PhilHealth’s system, noting that digitization will help flag questionable claims.
“Kasi kapag naipasatupad namin iyong digitization ay magagawa rin natin na iyong mga claims ay mapa-flag din iyong mga claims na maaaring sumusobra o iyong maaaring kung tawagin ay may halong kataka-taka kung bakit ganoon kalaki iyong mga claims nila (Because once we implement digitization, we will also be able to flag claims that may be excessive or, as some might say, suspicious as to why they are so large),” he said.
In response to inquiries about his extensive selection process for the position, Mercado credited a combination of his hospital administration experience, clinical expertise, and academic background.
“Marami po ang kinunsidera ng mga pumipili. Pero ako po ay may kakaibang, kumbaga, skills siguro dahil bukod sa ako ay hospital administration, ako po ay clinician. At ako ay also a researcher. Naging researcher ho ako through Harvard University sa School of Medicine, at ako rin po ay nakapag-aral ng health economics (Many candidates were considered for the position. However, I believe I have a unique skill set because, aside from my experience in hospital administration, I am also a clinician. Additionally, I am a researcher—I was a researcher at Harvard University’s School of Medicine, and I also studied health economics),” he said.
When pressed on what convinced him to accept the post, he simply replied, “Pinagdasal. Pero hindi ko maatim na iyong pasyente ay nahihirapan (I prayed about it. But I couldn’t bear to see patients struggling).”
When asked about PhilHealth’s current financial standing, he admitted, “Ang mayroon lang ho akong visibility, naka-post doon sa website ng Philhealth which is outdated kasi the latest audited financial statement is 2022. So, bigyan ninyo lang po ako ng oras para aralin po iyong mga subsequent [unclear] at babalikan ko po kayo ng mas klarong sagot doon sa tanong ninyo po (The only information I have access to is what’s posted on PhilHealth’s website, which is outdated since the latest audited financial statement is from 2022. So, please give me some time to review the subsequent [unclear], and I will get back to you with a clearer answer to your question).”