There has been a noticeable downturn in the use of PhilHealth’s Konsulta program, PhilHealth President and CEO Dr. Edwin Mercado said during his first press briefing as PhilHealth chief on February 5, 2025.
Otherwise known as Konsultasyong Sulit at Tama, PhilHealth Konsulta is a benefit package that provides free outpatient consultations, health screenings, selected diagnostic tests, and essential medicines. Under PhilHealth Circular No. 2024-0013, accredited Konsulta healthcare providers receive capitation payments per registered beneficiary, with patients not needing to pay directly for these services.
The program also aims to strengthen access to preventive medical care, the Circular added.
While every Filipino is automatically enrolled in PhilHealth under the Universal Health Care (UHC) Act, this does not mean they are automatically enrolled in the Konsulta program.
Mercado said must still register with their preferred Konsulta provider, and added that only 90% – or 102.75 million Filipinos out of 112.88 million – are registered as PhilHealth members, with only 24.6% of them, or 27.8 million, registered with Konsulta providers.
Advocates then estimate that only 6.37 million, or 5.6% of the population, had a first-patient encounter with their primary care provider or had their basic health data recorded.
This led some advocates to speculate that only a measly 1% of the population benefited from the Konsulta program in 2024.
Mercado said this can be attributed to low information dissemination. This can also be linked to the fact that only 88% of the 1,642 cities and municipalities in the country have any accredited Konsulta providers.
“Even if we are providing many benefits under the Konsulta program, if the Filipinos do not have access to them because there are only a few hospitals and facilities that are accredited to offer them, then the program will not succeed,” Mercado said.
“We need a full [national] approach to address this. Our responsibility at PhilHealth is to expand our benefit packages, but health-care providers also need to join us. This is the only way that we can help Filipinos in lowering their out-of-pocket health-related expenses,” he added.
As of March 2025, there are 2,661 government-run and 488 privately owned Konsulta provider institutions – a total of 3,149 – or only a quarter of the 12,765 PhilHealth-accredited facilities nationwide.
