Dr. Edwin Mercado, recently appointed as the president and CEO of the Philippine Health Insurance Corporation (PhilHealth), has promised to tackle the organization’s deep-rooted problems, which he metaphorically described as ‘illnesses’ requiring immediate attention. After taking his oath in front of President Ferdinand R. Marcos Jr., Mercado outlined his strategy to reform PhilHealth during a press conference at Malacañang.
Mercado, who brings 35 years of experience as a US-trained orthopedic surgeon and hospital manager, identified critical areas for improvement such as benefits management, claims processing, and financial reporting. He stressed the importance of a detailed review of PhilHealth’s operations to enhance service delivery and broaden the benefits available to Filipinos.
Drawing on his medical background, Mercado likened his role at PhilHealth to that of a doctor diagnosing and treating a patient. He emphasized the need to study and modify existing processes to fulfill the President’s directive of continuous and expanded service.
A significant part of Mercado’s reform plan involves the digitalization of PhilHealth’s operations. He believes that a digital system will not only streamline claims processing but also minimize fraud and increase transparency. By implementing digital tools, Mercado aims to flag and investigate unusually large or suspicious claims, thereby preventing system abuse and ensuring that public funds are used effectively to meet the healthcare needs of Filipinos.
Mercado also plans to assess the performance and organizational structure of PhilHealth’s staff to ensure they align with the agency’s new strategic direction.