Mercado's Prescription for PhilHealth Digitization, Transparency, and Patient-Centered Care This title effectively captures the main themes of the article, which are Edwin Mercado's plans to reform the Philippine Health Insurance Corp. (PhilHealth) by prioritizing digitization, transparency, and patient-centered care. The use of a medical metaphor (prescription) adds a clever touch, emphasizing the idea that Mercado is offering a solution to PhilHealth's problems.

Here's the edited blog post

Title Mercado's Prescription for PhilHealth Digitization, Transparency, and Patient-Centered Care

The newly appointed President and CEO of the Philippine Health Insurance Corp. (PhilHealth), Edwin Mercado, has vowed to revolutionize the state health insurer, bringing a much-needed injection of change to address long-standing issues plaguing the organization.

Identifying the Problems

As a physician himself, Mercado understands the frustrations healthcare providers face when dealing with PhilHealth, and he's determined to put an end to the inefficiencies that have marred the organization. His first priority is to review and refine PhilHealth's processes to ensure efficiency and eliminate financial leaks.

Addressing Wastage

One of the key issues Mercado wants to address is wastage, which has made it difficult to track the agency's financial health. To achieve this, he plans to standardize financial reporting, making it consistent and transparent. This will enable PhilHealth to make informed decisions and improve its financial management.

Combatting Fraud and Improving Claims Processing

Mercado stresses the need for a long-term solution through digitization to prevent fraud and improve claims processing. This will enable PhilHealth to adjudicate claims efficiently and determine the actual funds needed for benefit distribution. The agency is also procuring tools to enhance membership tracking and claims adjudication.

Enhancing Benefit Management

Building on reforms initiated by his predecessor, Mercado aims to increase benefits for members while working with hospitals to discuss how this increase can be deducted from existing professional fees and hospital fees.

Prioritizing Patient-Centered Care

As a doctor, Mercado understands the importance of reducing catastrophic healthcare expenses for PhilHealth members. To achieve this, he plans to analyze which illnesses most commonly lead to catastrophic healthcare expenses and develop an evidence-based standard of care in medical procedures. This will help reduce the financial burden on patients and ensure they receive quality care.

Fostering a Unifying Approach

Mercado's approach will engage healthcare providers to follow these standards as part of a whole-of-nation approach. He'll also incentivize those who comply with these standards by expediting payment cycles, encouraging cooperation and improvement in the healthcare system.

Compliance with Supreme Court Ruling

PhilHealth will abide by the Supreme Court's ruling on the transfer of excess funds to the National Treasury, which has already transferred P60 billion and plans to transmit a total of P89.9 billion in the coming weeks.

Conclusion

Mercado's commitment to revolutionizing PhilHealth is a welcome development for healthcare providers and patients alike. By prioritizing digitization, transparency, and patient-centered care, he hopes to put an end to the inefficiencies that have plagued the organization. With his unifying approach and evidence-based standard of care, Mercado is poised to lead PhilHealth towards a brighter future.

Keywords Philippine Health Insurance Corp., PhilHealth, healthcare reform, digitization, transparency, patient-centered care

Edward Lance Arellano Lorilla

CEO / Co-Founder

Enjoy the little things in life. For one day, you may look back and realize they were the big things. Many of life's failures are people who did not realize how close they were to success when they gave up.