, Singapore
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MOH declares new fee benchmarks in Singapore private healthcare

The benchmarks are effective in moderating growth of private surgeon charges.

Amidst rising healthcare costs, the Ministry of Health (MOH) in Singapore announced new fee benchmarks for hospital fees, and surgeon and anaesthetist professional fees for the private healthcare sector.

The key changes are: (a) benchmarks are adjusted to take into account cost increases; and (b) introduction of new benchmarks for hospital charges and professional fees. 

 

Since its introduction, close to nine in 10 doctors have been charging within the advised surgeon fee benchmarks. The median private surgeon fee has remained stable, while the 90th percentile private surgeon fee has decreased by about 1.7% for procedures with fee benchmarks.

In a statement, MOH said the new fee benchmarks include: “a) Hospital fee benchmarks for 29 common surgical procedures and medical conditions; and b) surgeon fee benchmarks for 2,100 procedures, anaesthetist fee benchmarks for 500 procedures, and doctors’ inpatient attendance fee benchmarks.”

Benchmarks revisions

To ensure that the benchmarks remain reflective of current costs and inflationary pressures faced by doctors, MOH has also adjusted all existing and new doctors’ professional fee benchmarks by a growth factor, which has considered key costs, such as manpower, rental and other operating expenses for the past years.

MOH has announced hospital fee benchmarks for 21 common surgical procedures and eight common medical conditions. Hospital fee benchmarks include fee components such as hospital room charges, surgical facilities and equipment, implants, consumables, investigations, general nursing services and treatment, and medication. However, hospital fee benchmarks exclude doctors’ professional fees (i.e., surgeon, anaesthetist and doctors’ inpatient attendance fees), which have separate fee benchmarks. 

Here is an illustration of cost component of hospital bill is as follows:

Figure 1: Illustration of cost components in a private hospital bill

Hospital Invoice

Billed by the doctor(s):

· Surgeon fees

Doctors fee benchmarks

· Anaesthetist fees

· Doctors’ inpatient attendance fees

Billed by the hospital:

(Some fee components below could also be charged by the doctors)

· Room charges

Hospital fee benchmarks

· Surgical facilities and equipment (e.g., use of operating theatre)

· Implants

· Consumables (e.g., gauze, swab)

· Investigations (e.g., radiology tests, laboratory tests)

· General nursing services and treatments (e.g., basic monitoring, taking regular blood test, administering drugs and/ or fluids prescribed)

· Medication

Total hospital bill

MOH also advised patients and payers to take note that some fee components of the hospital fee benchmarks could be charged by the treating doctor, but billed through the hospital. 

Such charging practices could vary across hospitals and doctors, even for the same procedure or medical condition, MOH added. 

“Patients can clarify with their doctor or hospital if in doubt over who the charging party is. Notwithstanding this, the hospital fee benchmarks provide a common reference for the reasonableness of the total fee billed by the hospital, regardless of the charging party,” said MOH.

Doctors and hospitals are strongly encouraged to be upfront on the fee components charged by them. 

Patients and payers may also be charged by doctors for their professional services, such as surgeon fees and anaesthetist fees. 

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