MANILA — Secretary of Health Dr. Teodoro J. Herbosa, along with members of the Philippine Health Insurance Corporation (PhilHealth) Board of Directors (Board) approved yesterday, Dec. 16, a P284 billion Corporate Operating Budget (COB) for Fiscal Year 2025.
The total amount is 10 percent higher than the previous year’s P259 billion COB. The Board also approved the Benefits Committee (BenCom)-endorsed second round of increases in selected case rates by as much as 50%. This is in addition to an emergency care benefit, glasses and optometric services for children, open heart surgery benefits, and pediatric cataract extractions.
The COB is PhilHealth’s version of a General Appropriations Act (GAA, for the national government) or a General Appropriations Ordinance (GAO, for local government units). The Board-approved COB 2025 already factors in the zero government premium subsidy for indirect contributors for 2025, as decided by the Bicameral Conference Committee (Bicam) of Congress.
It includes computations by PhilHealth Management of a P150 billion surplus as of October 31, 2024. The formula used is accumulated net income (also known as accumulated revenues) over the years of P431 billion, minus the Reserve Fund ceiling of P281 billion.
Within the 2025 COB is the amount of P271 billion programmed for benefit expenses, higher by 11 percent compared to FY 2024. This increase takes into account Board-approved increases in case rates, Z benefits, PhilHealth Konsulta at P1,700 and P2,100 capitation per person, and 156 hemodialysis sessions at P6,350 per session. It also includes funds for emergency care, outpatient mental health, severe acute malnutrition, and many other standalone outpatient packages. Despite the increase in the budget for benefits, the Board approved an increase of only 3 percent for administrative expenses, from P12.1 billion in FY 2024 to P12.5 billion in FY 2025.
Capital expenditures in the PhilHealth COB 2025 were pegged at only P259 million, which is 91 percent less than the approved equivalent in FY 2024 at P2.9 billion.
The Board observed that Management used only 8 percent of its COB 2024 for the purchase of information and communications technology (ICT) and other capital expenditures. While it did not grant a new ICT budget for FY 2025, the Board extended the validity of the COB 2024 for ICT projects in the amount of P989 million to ensure that digitalization is prioritized.
“PhilHealth has a lot of money, well over the reserve fund ceiling allowed by law. This surplus is a result of underspending for benefits through the years, which is why Filipino families pay high out of pocket,” said Secretary Herbosa.
“The Board approved higher benefits and a budget for 2025 that recognizes the need for PhilHealth to spend more so that families will spend less,” the Health Chief explained.
The PhilHealth Board of Directors chaired by the Secretary of Health (who cannot vote) has four other ex-officio members that include the Secretaries of Finance, Budget and Management, Social Welfare and Development, and Labor. It also has three expert panel members and four sectoral members. Another seat for a representative of local chief executives remains vacant. The Board is separate & distinct from PhilHealth’s Executive Officers, led by its President and Chief Executive Officer (PCEO) Emmanuel R. Ledesma, Jr. and Executive Vice President and Chief Operating Officer (EVP/COO) Eli Diño D. Santos. (DOH)
