The Philippine Health Insurance Corp. (PhilHealth) plans to pilot a global-budget payment system that could give hospitals funding upfront, as it expands no-balance-billing options and seeks to cut patients’ out-of-pocket healthcare costs.
Newly appointed PhilHealth President and CEO Beverly Ho said the pilot will involve hospitals that support the government’s universal healthcare goals.
“In the coming months, we aim to implement a pilot program on global budget, where payments can be front-loaded to hospitals that are aligned with our thrust, to further expand no-balance-billing options and predictable copayment for Filipinos,” Ho said.
She spoke during the signing of an agreement between PhilHealth and St. Luke’s Medical Center-Global City, witnessed by President Ferdinand Marcos Jr. on Tuesday.
Ho said St. Luke’s could help PhilHealth through cost analysis, Claim Form 5 shadow billing, and monitoring of quality and patient outcomes.
Claim Form 5 records the actual services and costs involved in treating patients. PhilHealth can use the data to better understand healthcare costs without immediately using itemized charges to determine payments.
The agreement also aims to strengthen PhilHealth benefit packages and the no-copayment policy at St. Luke’s.
Ho said about 1.2 million Filipino families face catastrophic health spending each year. Heavy medical bills can push patients to delay treatment, allowing illnesses to worsen and costs to rise.
Households are still shouldering a large share of medical expenses. Out-of-pocket spending accounted for 45 percent of total healthcare costs when Marcos took office. That share fell to 41 percent by the end of 2025, Ho said.
The global-budget pilot could change how PhilHealth pays hospitals. Instead of relying mainly on individual claims, the insurer could provide more predictable funding while tying payments more closely to costs, quality, and patient outcomes.
Marcos urged more private hospitals to adopt PhilHealth’s no-copayment policy.
He said stronger private-sector participation would help ensure that financial constraints do not prevent Filipinos from getting needed medical care.
The bigger goal for PhilHealth is to make healthcare costs less of a surprise, both for hospitals planning their finances and for patients facing a medical bill.
