Singapore Insurers Backs MOH Benchmarking

The life insurance industry in Singapore is supportive of the Ministry of Health's (MOH) initiative to introduce a set of national benchmarks, starting with professional fees for medical procedures, says the Life Insurance Association Singapore (LIA Singapore).

LIA Singapore announced its backing in a statement yesterday following the publication by MOH of benchmarks for private sector professional fees for common surgical procedures. The benchmarks will guide private sector healthcare providers in charging appropriately and enable patients and payers to make more informed decisions.

The benchmarks were developed by the Fee Benchmarks Advisory Committee chaired by Dr Lim Yean Teng. The Committee was appointed by MOH in January 2018 to develop an approach for setting reasonable fee benchmarks, and recommend the fee benchmarks for surgical procedures and services. The Committee’s recommendations have been accepted in full by MOH.

Wider strategy - The development of fee benchmarks is part of a larger strategy to ensure that healthcare costs remain affordable and Singapore's healthcare system sustainable. The initiative complements other measures, such as the publication of appropriate care and drug guidances, introduction of a co-payment requirement for new Integrated Shield Plan (IP) riders, and quality and cost benchmarking for the public healthcare providers. An IP is an insurance plan sold by private insurers that gives coverage additional to that offered under the government-run basic medical insurance scheme, MediShield Life, and provides the policyholder the option to be treated in private hospitals or higher class wards in public hospitals.

In developing the benchmarks, the Committee referenced data including actual recent transacted fees and inflation. It also considered other factors such as the complexity of the procedure, and the time, effort and expertise required of the professional for typical cases, so as to ensure that the fee benchmarks reflect a fair range of professional fees for the procedure.

To balance stakeholder interests and perspectives, the Committee consulted extensively with multiple stakeholders, including medical professionals, hospital administrators, advocacy groups such as the National Trade Union Congress and the Consumers Association of Singapore, and insurers and regulators.

Future phases of fee benchmarks - MOH will consult the Committee and relevant stakeholders to identify additional areas in which new fee benchmarks could be developed in future. The Committee will also look into the frequency and approach of how the published fee benchmarks could be periodically reviewed to ensure that they remain relevant.

Dr Lim said, “Ultimately, the effectiveness of the fee benchmarks developed will depend on how well it is accepted and used by the various stakeholders. As long as there is concerted and collective effort in applying them, the Committee hopes that it will help to moderate the rising healthcare costs in Singapore.”

The fee benchmarks can be found on the Ministry of Health’s website, at www.moh.gov.sg/billsandfees.

Stakeholders - The MOH encourages patients to use the benchmarks to have a conversation with their doctor on their treatment, the complexity of their condition and the fees charged.

Medical providers and professionals should take reference from the benchmarks to set appropriate charges and make reference to it when advising their patients.

The fee benchmarks also support payers such as insurers in taking an active approach in their claims assessment, product design and selection of preferred healthcare providers for their panel.

Insurers - LIA Singapore, in its statement, also said that insurers will have an additional reference point when reviewing whether the fees being claimed are “reasonable and customary”. It will help to mitigate cases of over-charging by providers and empower insurers to detect inflated claims and take an active approach towards claims adjudication.

The association said, “Going forward, panel arrangements remain an important initiative for IP insurers in Singapore. Such arrangements enable IP insurers and healthcare providers to work together to provide consumers an improved experience. The fee benchmarks will support efforts to manage overall medical costs by providing an additional source of guidance for IP insurers when establishing and working with their panels of preferred healthcare providers. Insurers are studying how the benchmarks will influence products in a way that is reasonable to other stakeholders, while ensuring that their healthcare protection plans remain sustainable in the long run.”