Beverly Lorraine Ho takes over as president and CEO of the Philippine Health Insurance Corporation (PhilHealth). (Photo courtesy of DOH ARSP)
PhilHealth’s push to expand benefit packages will depend heavily on whether the country can reduce costly illnesses through stronger primary care and prevention, according to newly appointed president and CEO Beverly Lorraine Ho.
Ho said a large share of the state health insurer’s payouts already goes to expensive treatments that could, in some cases, be avoided or delayed through earlier intervention. She cited dialysis, which accounts for at least 15 percent of PhilHealth benefit payments.
She said better control of risk factors, including high salt intake, and more effective health promotion could reduce the number of patients who eventually develop conditions requiring long-term dialysis.
The issue is becoming more important as PhilHealth is under pressure to widen coverage and increase benefits while keeping the fund financially sustainable over the long term.
Ho also pointed to the need for continued government support for indirect contributors, whose premiums are subsidized, while direct contributors were encouraged to keep their payments up to date.
She said a more reliable contribution base would help PhilHealth maintain and expand services while avoiding a situation where benefit growth outpaces available funding.
PhilHealth is also set to work more closely with the Department of Health under a Unified National Agenda for Health, with the two agencies expected to divide roles between prevention and actual access to care.
Ho said PhilHealth is expanding its Yaman ng Kalusugan Program, or YAKAP, in schools and workplaces to improve access to consultations and medicines, while the DOH focuses on health promotion, health literacy and coordination across government agencies.