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PhilHealth: President In Action: Acting President and CEO Dr. Edwin Mercado convenes the Technical Advisory Council to refine disease coverage selection process

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by Info @Brand Zone | Mar. 14, 2025



Council Members consist of Dr. Tessa Tan-Torres Edejer, health economist who served as  the Coordinator of the Unit on Costs, Effectiveness, Expenditure and Priority Setting in the  Department of Health Financing and Governance (HGF), WHO in Geneva; Dr. Carlo Irwin  A. Panelo, health systems, policy and financing expert; Honesto A. Nuqui, Jr., actuary,  mathematician, and seasoned insurance executive; Dr. Michael L. Tee, university professor,  scientist, and chancellor; Dr. Valerie Gilbert T. Ulep, health economist and well-published  senior research fellow; Dr. Vivencio Jose Villaflor, a practicing surgeon and seasoned  hospital administrator; and Henry Aguda, information technology and digital transformation  expert.

.PhilHealth PR No. 2025-15 | March 13, 2025 | Reference:  Dr. Israel Francis A. Pargas


The PCEO Mercado convened the Technical Advisory Council (TAC) for its second meeting  on March 10, 2025. The session focused on improving actuarial assumptions and refining  the disease coverage selection process. 


During the meeting, experts discussed practical ways to strengthen actuarial projections that  will directly benefit PhilHealth members. The council emphasized the need for more detailed,  market-based assumptions that assess whether current healthcare providers can actually  deliver the covered services.  


"By improving our actuarial assumptions, we can better predict healthcare costs and  utilization patterns," explained the PCEO Mercado. "This means we can expand benefits in a  sustainable way while ensuring members can actually access the care we're promising." 


The TAC supported the President and CEO's direction to expand coverage for high-cost,  high-burden diseases to increase access to critical services. For members, this translates to  greater financial protection against catastrophic health expenses that previously caused  significant hardship for many Filipino families. 


"Going granular means understanding if our current healthcare infrastructure can deliver the  services we're covering, and developing strategies to create robust markets where they don't  exist. Ang ibig sabihin po nito, alam natin hindi lang kung nasaan ang mga doktor at iba pang  mga propesyonal, ngunit alam din natin kung ilang pasyente ang kaya nilang tingnan sa  isang araw nang hindi bumababa ang kalidad ng serbisyong pang-medikal," added the  PhilHealth President and CEO. "When we promise coverage for a condition, we want to  ensure our members can find qualified providers to deliver that care without excessive out of-pocket expenses or long travel times." 


Council members committed to developing a practical framework that will guide this  expansion while ensuring service delivery capability.



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