PhilHealth to undergo major revamp —GCG
The Governance Commission for Government-Owned or -Controlled Corporations (GCG) on Wednesday said the Philippine Health Insurance Corporation (PhilHealth) will undergo restructuring to improve its efficiency and solve operational issues.
'The restructuring includes a revamped organizational structure with 503 units and a total of 7,149 positions designed to improve service delivery and strengthen the agency's capability to fulfill its expanded mandate under the Republic Act (R.A.) No. 11223 or the 'Universal Health Care Act,' GCG said in a statement.
"This major revamp aims to enhance PhilHealth's efficiency and address key operational challenges," it added.
Among the issues it aimed to address are the outdated workforce, fragmented data, strategy execution, and issues related to benefit claims.
CGC also identified the five critical services to be centralized: finance, legal, information technology, procurement, human resources, and general administration services.
'The centralization of these administrative functions is seen to address the inconsistencies and conflicts in the current operational framework of PhilHealth, maintain responsiveness to the public, and enhance healthcare delivery,' CGC said in a press release.
To ensure checks and balances, the internal audit office of PhilHealth was also ordered to report to the Audit Committee of the Board of Directors and shall administratively report to the President and Chief Executive Officer (PCEO) of the corporation.
The Benefit Payment Appeals Office (BPAO) will be established to handle appeals related to benefit claims payments. It aims to improve the handling of appeal cases and incentivize healthcare.
In a separate statement, Health Secretary Teodoro Herbosa said the agency has been working with the GCG on the restructuring of PhilHealth.
'The Department of Health (DOH) has been working with the Governance Commission for GOCCs (GCG) to ensure that the organizational structure of PhilHealth is suitable for the implementation of Universal Health Care,' Herbosa said. —LDF, GMA Integrated News
'PhilHealth staff and especially the public have been waiting for this reorg for a long time. The DOH and the entire Board of Directors have paid close attention to every detail,' he added.
Last year, the GCG approved a partial restructuring of PhilHealth following its initial application in 2022.
To aid in the evaluation process, GCG requested that PhilHealth provide additional documentary requirements and undergo consultation from May 2023 to January 2025.
- Mariel Celine Serquiña ###
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