CREATING PUBLIC VALUE AMIDST CRISIS: A CASE STUDY OF PHILHEALTH’S FINANCIAL RESILIENCE IN ZAMBOANGA CITY, PHILIPPINES DURING THE COVID-19 PANDEMIC

Abstract

The COVID-19 pandemic acted as a global "value crisis," testing the resilience of health financing systems (SDG 3). This study evaluates the institutional performance and resilience of the Philippine Health Insurance Corporation (PhilHealth) in Zamboanga City (SDG 16)  through the lens of Public Value Management (PVM). Utilizing a qualitative case study design, the research triangulates data from Key Informant Interviews (KIIs) with stakeholders and a systematic review of government advisories and institutional reports covering the period from March 2020 to February 2023. Findings reveal that while global health financing faced severe disruption, PhilHealth in Zamboanga City demonstrated remarkable resilience in maintaining financial risk protection. The "public value" of health equity was upheld through the continuous implementation of the No Balance Billing (NBB) policy and Point-of-Service (POS) enrollment, shielding vulnerable residents from catastrophic out-of-pocket expenses. Operational capacity was significantly bolstered by the timely digitization of claims processes and the successful scale-up of the KonSulTa program, which transitioned the system’s focus from reactive inpatient coverage toward proactive primary care. This institutional stability is credited to a "Whole-of-Government" approach facilitated by the Universal Health Care Act (RA 11223), allowing for coordinated inter-agency responses and sensitive fiscal adjustments, such as premium payment extensions. The study concludes that localized resilience is achievable when public value is supported by strong legal mandates and adaptive digital strategies. Recommendations include institutionalizing paperless systems, formalizing crisis-adaptive business continuity plans, and expanding primary care packages to ensure the long-term sustainability of universal health care.