PhilHealth to restructure with new org framework

The Governance Commission for Government-Owned or -Controlled Corporations (GCG) announced on Wednesday that the Philippine Health Insurance Corporation (PhilHealth) will undergo restructuring to enhance efficiency and address operational issues.

The restructuring includes a new organizational structure with 503 units and 7,149 positions aimed at improving service delivery under the Universal Health Care Act.

Key challenges addressed include an outdated workforce, fragmented data, strategy execution problems, benefit claims issues, and financial losses.

Five critical services—finance, legal, IT, procurement, HR, and general administration—will be centralized to resolve inconsistencies in PhilHealth's operational framework.

An internal audit office will report directly to the Audit Committee of the Board of Directors and the President and CEO for better accountability.

A Benefit Payment Appeals Office (BPAO) will handle benefit claims appeals, aiming to improve case management and incentivize healthcare.

PhilHealth has one year to implement these changes and must submit quarterly reports to allow the GCG to monitor progress.