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Guide To MOH Fee Benchmarks For Private Hospital, Surgeon, And Anaesthetist Fees

Greater transparency over medical costs will enable consumers to make more informed decisions.

An ageing population, access to new (and expensive) treatments due to medical advancements, and rising manpower costs—are some of the reasons mentioned to explain the higher-than-expected increases in healthcare costs. In fact, the median private hospital fee rose by an annual compounded growth rate of 4.5% from 2007 to 2022, which is double the inflation rate of 2.11% over the same period.

To manage rising healthcare costs, the Ministry of Health (MOH) first published the private surgeon fee benchmarks for 222 common surgical procedures in 2018. Since then, private doctor fees for surgeries with the published fee benchmarks have moderated and increased by around 2.3% to 2.8% per year from 2017 to 2022.

In the latest review in 2023, the fee benchmarks for the private healthcare sector have been expanded to include private hospital fees and more benchmarks for private surgeon professional fees and private anaesthetist professional fees. This would not only provide a more complete reference for private doctors and patients but could also help moderate rising healthcare costs.

What Are Fee Benchmarks For Private Healthcare Sector

The Fee Benchmarks serve as a reference point for patients, insurers, and private healthcare providers on what is typically charged for certain procedures. It allows the stakeholders to gauge whether the private doctor fees charged are reasonable or excessive.

First published by MOH in November 2018, the fee benchmarks were developed through consultation with an independent Fee Benchmarks Advisory Committee (FBAC) comprised of doctors, consumer advocacy groups, insurers, and academia as part of MOH’s strategy to control rising healthcare costs.

The fee benchmarks are indicated as a range between the 25th and 75th percentiles of actual hospital bills. You can use the lower end of the range to gauge whether the fees are reasonable for routine cases, while the higher end of the range is indicative for cases with slightly more complex treatments.

Along with the annual publication of hospital bill sizes, the fee benchmarks are intended to keep healthcare costs affordable by increasing fee transparency and reducing information asymmetry among patients, providers, and payers.

What Are The Latest Changes To The Fee Benchmarks For Private Healthcare Sector

With the latest round of review in 2023 by the FBAC, the fee benchmarks have been expanded as follows:

#1 Hospital Fee Benchmarks Introduced For 21 Common Surgical Procedures And 8 Common Medical Conditions

The latest round of changes to the fee benchmarks now encompasses hospital fee benchmarks for 21 common surgical procedures and 8 common medical conditions. With this information, you would be able to know whether hospital-related charges such as hospital room charges, surgical facilities and equipment, implants, consumables, investigations, general nursing services and treatment, and medication are reasonable or excessive.

Nevertheless, there could be times where some fee components, like hospital room charges and implants, could be charged by the treating doctor but billed through the hospital. In such cases, you should separate them when making the comparison.

#2 Surgeon Fee Benchmarks Now Available For 2,100 Surgical Procedures

Since the initial list of 200 common surgical procedures for private surgeon fee benchmarks were introduced in 2018, another 1,900 surgical procedures will be added. This covers all the surgical procedures that can be claimed under MediSave and MediShield Life.

#3 Anaesthetist Fee Benchmarks Expanded To 500 Procedures Requiring Anaesthesia Support

On top of the 200 anaesthetist fee benchmarks that were published in 2020, a further 300 anaesthetist fee benchmarks would be published in the latest round of reviews. This would increase coverage by an additional 5%, or to 95% of all procedures requiring anaesthesia support in the private sector.

While there are another 600 procedures that require anaesthesia support, the FBAC has no plans to publish those benchmarks as they are rarely performed and are not requested by stakeholders.

#4 Doctors’ Inpatient Attendance Fee Benchmarks Adjusted For Inflation

First published in 2020, the doctors’ inpatient attendance fee benchmarks provided a complete reference for all areas of doctors’ professional fees. In the latest review, the rates were adjusted for growth up to 2022 to ensure they remained relevant, accounting for inflation. The adjustment considers the cost of manpower, clinic rental, and other operating expenses.

The next review could be carried out in 3 to 5 years’ time to make any updates to changes in prices caused by inflation.

How Does The Fee Benchmarks Help With Private Healthcare Costs

According to MOH, since its introduction in 2018, close to 90% of doctors have been charging within the recommended fee benchmarks for surgeon fees. This has helped to not only keep the median private surgeon fee stable but has also caused the 90th percentile private surgeon fee for procedures with fee benchmarks to drop by about 1.7%.

This shows that, though the fee benchmarks are not mandatory, they have helped moderate the rise in healthcare costs as a result of greater transparency. It has also instilled discipline in the private healthcare sector when charging for routine cases.

As the initial benchmark surgeon fees did not cover around 1,900 surgical procedures, the latest move is expected to not only address it but also cover other private healthcare costs. With the expanded scope, it is expected that the growth of other private healthcare costs will grow at a more sustainable rate.

How Can Patients And Payers Use The Fee Benchmarks

You can use the fee benchmarks, including the hospital bill size information published on the MOH’s website, as references when choosing between public or private care and treatment options.

As the fee benchmarks provide a range, the actual fees charged by doctors or hospitals could differ depending on the complexity of the case. However, you can expect to pay around the lower end of the fee benchmarks for less complex cases or at around the higher end of the range for more complex cases. However, do note that in rare cases of exceptional complexity, the fees charged may exceed the fee benchmarks due to the additional risk, time, and effort required for the procedure.

You can also use the fee benchmarks to understand the different cost components of the bill charged by the hospital. Some of the costs (e.g., implants and consumables) could be charged by either the doctor or the hospital. To this end, you could clarify if there’s any doubt over who the charging party is with the hospital. You can also seek clarification if the fees charged by doctors or hospitals are above the benchmarks to get a better understanding of the reasons.

In short, the fee benchmarks empower consumers, whether as patients or payers, to make informed decisions with greater price transparency.