SINGAPORE — For the first time, patients can now check the recommended private hospital fees for 29 common surgical procedures and medical conditions such as cataract surgery and asthma, the Ministry of Health (MOH) said on Wednesday (June 14). 

The ministry has also greatly expanded an existing list of recommended fees for surgeons and anaesthetists to cover many of the procedures that can be claimed under MediSave and MediShield Life.

Recommended fees for 200 common surgical procedures were introduced in 2018. This was expanded in 2020 to include some anaesthetist fees and doctors' inpatient attendance fees.

As part of MOH's wider strategy to manage rising healthcare costs, the fee benchmarks are MOH’s recommended charges for a particular medical procedure or service.

In a media release on Wednesday, MOH said that while the recommended fees are not mandatory, the system had helped to "moderate" fee increases since it was introduced in 2018 and expanded in 2020.

The new recommended fees can be accessed via MOH's website from Wednesday. 

MOH said it has updated the surgeon, anaesthetist and doctors’ inpatient attendance benchmark fees that were introduced in 2018 and 2020. 

The benchmark surgeon fees have increased by 12.1 per cent, anaesthetist fees by 9.9 per cent and doctors' inpatient attendance fees by 5.7 per cent. 

MOH said inflation was a key factor for this update.

This is to ensure that these benchmark fees remain current, following the rising costs in manpower, rental and other operating expenses, MOH said. 

WHY IT MATTERS 

The benchmark fees for private hospitals and clinics were reintroduced in 2018, 11 years after the Singapore Medical Association was ordered to remove its fee guidelines by the competition authorities.

The independent Fee Benchmarks Advisory Committee, which advises MOH, said in 2018 that fees had gone up “significantly without a corresponding underlying reason for the growth”.

For example, most who needed simple foot fracture surgery in 2017 incurred surgical fees of between S$4,280 and S$6,420, but the committee evaluated that reasonable rates should have been between S$4,000 and S$5,350.

The list of recommended charges, including the new hospital fee benchmarks, is part of efforts to stem rising healthcare costs. 

It also serves as a guide to help patients, healthcare providers and insurers make more informed decisions. 

In its media release on Wednesday, MOH said that close to 90 per cent of doctors have been charging within the recommended surgeon fee benchmarks. 

It added that the median private surgeon fee has remained stable, while the 90th percentile private surgeon fee has decreased by about 1.7 per cent for procedures with fee benchmarks. 

“Overall, while not mandatory, fee benchmarks have fostered price transparency, instilled discipline in charging and helped moderate increases in fees,” MOH said. 

WHAT ARE THESE BENCHMARKS? 

From Wednesday, patients can check the recommended costs for the following: 

• Surgeon fees for all 2,100 surgical procedures that can be claimed under MediSave and MediShield Life. Prior to this, recommended fees for 200 common surgical procedures were introduced in 2018. They accounted for 85 per cent of surgical cases in the private sector
• Anaesthetist fees for 500 procedures that can be claimed under MediSave and MediShield Life. Prior to this, recommended fees for 200 procedures which accounted for around 90 per cent of private hospital cases requiring anaesthesia support were introduced in 2020
• Doctors’ inpatient attendance fee for hospitalisation stays, which was introduced in 2020 
• Hospital fees for 29 common surgical procedures and medical conditions 

The newly introduced benchmark hospital fees were calculated based on hospital bills in 2021 and the first half of 2022 for private day surgery clinics and private hospital cases for Singapore citizens, exclusive of the Goods and Services Tax. 

The benchmark was then set at the 25th to 75th percentile of the hospital bill by default, said MOH. 

It added that the 29 surgical procedures and medical conditions were decided based on the volume of cases as well as those with fairly standardised management, among other factors. 

The hospital fee benchmarks include fee components such as:

• Hospital room charges
• Surgical facilities and equipment
• Implants 
• Consumables
• Investigations
• General nursing services and treatment 
• Medication 

However, MOH said that certain fee components could be charged by the treating doctor but billed through the hospital. 

For instance during cataract surgery, a surgeon could order and charge for a lens implant but bill it through the hospital. 

“In this situation, if the patient or payer has questions on the cost of the lens implant, they should enquire with the doctor directly,” said MOH. 

The ministry added that healthcare providers should refer to and quote the relevant fee benchmarks when providing financial counselling to patients. 

“Patients are also encouraged to use the relevant fee benchmarks and hospital bill size information found on MOH's website as references for cost comparison when considering care options,” it said. 

In the event of a clinical-related claim dispute between Integrated Shield Plan policy holders, insurers or healthcare providers, parties may file their dispute with the Clinical Claims Resolution Process (CCRP), MOH said. 

The CCRP handles disputes over issues such as over-charging by medical practitioners and medical institutions, as well as unfair rejection of claims for treatment or procedures. 

In response to TODAY's queries on how the new benchmarks will help patients, orthopaedic surgeon Toh Choon Lai said that patients feel more assured if they have an idea of how much a procedure will cost.

This is despite many Singaporeans having insurance plans which will pay for their medical expenses, said Dr Toh, who is a council member of the Singapore Medical Association.

"With the benchmarks covering surgeon fees, anaesthetist fees and hospital fees, estimation of their hospitalisation cost becomes much easier for patients," he said. 

Dr Toh added that he would like to see such fee benchmarks adjusted regularly based on inflation, to better reflect practice costs.