MOH responds to Great Eastern’s suspension of pre-authorisation for Mount Elizabeth
The Ministry of Health (MOH) is currently engaging in talks with insurance group Great Eastern (GE) to understand its most recent decision.
On 17 June, the group announced its temporary suspension of pre-authorisation certificates for its policyholders admitted to Mount Elizabeth hospitals.
With pre-authorisation, the insurer approves the medical treatment, including the costs, before admission.
A spokesperson said to MS News that this move is an effort to “manage rising healthcare costs and ensure long-term affordability for all policyholders”.
MOH told the media that the affordability of major medical expenses is understandably a concern for Singaporeans.
While all Singaporeans are covered by MediShield Life, which is sized to provide for large subsidised bills, they can also purchase Integrated Shield Plans (IPs) or additional coverage.
The health ministry said that as IPs are commercial products, changes to administrative processes, such as pre-authorisation frameworks, are based on the individual insurer’s commercial considerations.
It added that IP insurers would have to “ensure that policyholders continue to be able to access the full benefits of their policies in accordance with the terms and conditions for claims, as stated in their policy contracts”.
Great Eastern pauses pre-authorisation for Mount Elizabeth admissions
Some reasons that led to this decision include the high costs of both Mount Elizabeth and Mount Elizabeth Novena hospitals compared to other private hospitals.
“The cost difference in total bill size typically ranges between 20%-30% but can sometimes go higher in some cases,” said a spokesperson from Great Eastern to MS News.
Source: Great Eastern
The Mount Elizabeth hospitals are owned by IHH Healthcare. They are the biggest private healthcare provider in Singapore, with four acute hospitals.
Its other two hospitals — Gleneagles and Parkway East — are not affected by GE’s pausing of pre-authorisation.
Policyholders can continue seeking care from Mount Elizabeth hospitals
GE said its policyholders can still seek treatment from the two hospitals without any changes to their benefits and claims.
The claims will continue to be processed accordingly via usual procedures.
This decision was not a reflection of their clinical quality, clarified GE.
Instead, they are “prioritising facilities that deliver the same high-quality care with greater cost transparency and cost-effectiveness”.
According to a GE spokesperson, policyholders have access to several options for the treatment they require through its medical care concierge.
The suggestions include both private and public hospitals, along with their respective costs.
“This service has been specially designed to provide peace of mind and transparency and help policyholders make informed decisions,” said the spokesperson.
Great Eastern’s move came as surprise: Mount Elizabeth Hospital CEO
Speaking to ST, Yong Yih Ming, Chief Executive Officer (CEO) of IHH Healthcare Singapore and Mount Elizabeth Hospital, said they had been in an “active discussion” with GE over the past few months.
“[We] are therefore surprised by GE’s unilateral move to suspend pre-authorisation for two of our hospitals before we could conclude the discussion,” he said.
The group disagreed with GE’s claim that Mount Elizabeth hospitals have higher prices, compared to private hospitals, for similar procedures and case profiles.
“Each of our hospitals has different focus and areas of excellence — Mount Elizabeth Hospital and Mount Elizabeth Novena Hospital house facilities and equipment that allow specialists to manage patients and perform surgeries that are not available at other hospitals,” stated Mr Yong.
“This is also why some of the more complex cases are managed at these two hospitals.”
Source: Mount Elizabeth
Mr Yong assured GE health policyholders that they would continue to have access to the care they need.
Patients who are in the midst of active medical care by specialists, or have past treatment records at both hospitals, would continue to have cashless access to hospital admissions.
Mr Yong added that these patients need not worry about cash outlay, despite GE’s suspension of pre-authorisation.
“We are also working closely with our specialists to avail price packages to patients, to help manage their cost of care,” he said.
Keeping protection ‘accessible and sustainable’
The GE spokesperson told MS News that, based on their observations over the past few years, certain private hospitals have been charging significantly more for similar treatment or the same clinical outcomes.
Pausing pre-authorisation helps GE address the issue of rising charges from the two hospitals.
The spokesperson further reassured policyholders that this does not impact their coverage or benefits.
As it stands, GE is in active discussions with the hospital group involved and the health ministry.
It added that this move is part of GE’s “responsibility to keep protection accessible and sustainable for everyone”.
Meanwhile, insurers Prudential and AIA have confirmed that they are still offering pre-authorisation certificates for all healthcare institutions.
Also read: Great Eastern Offers S’pore Residents Free Covid-19 Protection Coverage, Registration Ends 30 Sep
Great Eastern Offers S’pore Residents Free Covid-19 Protection Coverage, Registration Ends 30 Sep
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Featured image adapted from Great Eastern and Mount Elizabeth.
