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CNA
8 hours ago
- Business
- CNA
Mount Elizabeth hospitals not always most expensive among private providers, CNA finds
SINGAPORE: Despite its reputation for premium pricing, Mount Elizabeth hospitals do not consistently charge the highest fees among private healthcare providers in Singapore, a CNA review of medical billing data has found. Based on typical bills for 10 common medical procedures listed on the Ministry of Health's (MOH) cost comparison portal, Mount Elizabeth topped the list in only three cases. The "typical bill" refers to the median cost paid by patients in 2023. While Mount Alvernia Hospital was found to be cheaper in some instances, it was excluded from CNA's comparison as it operates as a not-for-profit institution. In the three cases where Mount Elizabeth was most expensive, Mount Elizabeth Novena charged 5.1 per cent more for a knee arthroscopy, 11.3 per cent more for hernia repair and 38.2 per cent more for an appendicectomy compared with the next-most expensive private hospital option. However, the same data showed that Mount Elizabeth is not always the costliest option. For example, fibreoptic colonoscopy day surgery and iridectomy at Mount Elizabeth Orchard and Novena were cheaper than at other private hospitals. Insurer Great Eastern announced on Tuesday (Jun 17) that it has stopped issuing pre-authorisation certificates for policyholders admitted to the two Mount Elizabeth hospitals. Such certificates are still available for other hospitals and day surgery centres, it said. Pre-authorisation refers to the insurer's approval of coverage for medical costs before treatment. 'In the last few years, we have observed that certain private hospitals have been charging significantly more than others for the same treatment, same clinical outcome, similar level of complexity, as well as for procedures that are less complex," the insurer said on Thursday in response to CNA's queries. "The cost difference in total bill size typically ranges between 20 and 30 per cent but can sometimes go higher in some cases.' Based on MOH data, the typical inpatient bill for a knee arthroscopy – a surgical procedure to diagnose problems within the knee joint – at Mount Elizabeth Novena was S$22,559 (US$17,560) and S$22,208 at Mount Elizabeth Orchard. It was cheaper at Gleneagles Hospital, which charged S$21,456. For an appendicectomy – removal of the appendix – Mount Elizabeth Novena charged S$30,808, compared with S$22,297 at Raffles Hospital, while for hernia repair, Mount Elizabeth Novena charged S$35,944, higher than the S$32,288 charged by Gleneagles. In contrast, iridectomy, a surgical procedure primarily to treat glaucoma, was cheaper at Mount Elizabeth Orchard (S$2,367) and Mount Elizabeth Novena (S$2,602) compared with Farrer Park (S$3,874). Beyond MOH's data, CNA reviewed itemised hospital bills from Mount Elizabeth Orchard, Parkway East and Gleneagles over the past two years. While Mount Elizabeth charged marginally more for common items such as hygiene sheets and lignocaine injections (1.7 to 7.7 per cent higher), it charged less for other items, such as ECG electrodes. Mount Elizabeth Orchard and Novena are operated by IHH Healthcare Singapore, the country's largest private healthcare provider. Other hospitals under its umbrella – including Gleneagles and Parkway East – are not affected by Great Eastern's pre-authorisation suspension. CNA contacted IHH and Great Eastern for comment on the pricing differences. In response, IHH said that comparing the typical bill sizes across hospitals and interpreting them at 'face value' is 'overly simplistic' and 'misleading' in reflecting each hospital's value and affordability. 'The Table of Surgical Procedures is a ranked listing of procedures that focuses on the intent and outcome of the surgical procedure. It does not reflect the surgical access route or the technologies, facilities and equipment used. Neither does it reflect the expertise and skill of the healthcare practitioners involved,' an IHH spokesperson said. The spokesperson also said that the two Mount Elizabeth hospitals, due to their level of 'equipping and capabilities', tend to take in more complex cases across all specialties, as doctors also make 'active choices' on where to admit patients based on the patient's best clinical interests. 'It is therefore natural that the average bill sizes seen at these two hospitals be higher compared to other facilities,' the spokesperson added. Great Eastern referred CNA to its previous statement. Great Eastern said earlier that the move is part of its efforts to manage rising healthcare costs and ensure affordability for its policyholders. "We want to assure our policyholders that there is no change to their coverage, and they can still receive treatment and submit claims as usual with no impact to their benefits," a spokesperson added. The IHH spokesperson said that their analysis of publicly available data from MOH does not correspond to Great Eastern's claims that bills at Mount Elizabeth hospitals are 20 to 30 per cent higher. They added that they have formally written to the insurer and are 'awaiting their response'. IHH previously expressed "surprise" at Great Eastern's move, saying it has been in active discussion with the insurer over the past few months. 'We do not agree with GE's claim about higher prices at two of our hospitals for similar procedures and case profiles," its group COO and Mount Elizabeth CEO Yong Yih Ming said on Wednesday. "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.' This is also why some of the more complex cases are managed at these two hospitals, he said. In response to media queries, MOH said on Thursday it is engaging Great Eastern to better understand the implications of its decision. Integrated shield plans (IPs) are commercial products, the ministry said. While MOH regulates the key parameters of these products for financial sustainability, insurers retain discretion over administrative processes like pre-authorisation. "However, 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," it added. MARKET DYNAMICS, COST STRUCTURE DRIVE PRICING VARIATION Experts told CNA that pricing differences across private hospitals are influenced by a range of factors, including the time and resources required and the hospital facilities used. 'Public hospital fees are subsidised by the government and are structured to ensure patient affordability. In contrast, private hospitals operate independently and need to factor in staffing, overheads, service-level costs and profitability when setting prices,' said Mr Joshua Siow, who is a partner at Simon-Kucher and its head of healthcare and life sciences in Singapore. For example, in the case of different drug prices, public hospitals rely on a centralised procurement system, which helps standardise prices across institutions, said Ms Verlene Law of The Reg Consultants, a regulatory service provider specialising in pharmaceutical and medical companies. Private hospitals procure drugs independently and prices can differ based on their supplier agreements and business models, she said. Private hospitals may also serve different patient segments or offer specialised clinical services that justify higher fees, said Mr Siow. "Patient experience, hospital infrastructure and differing target customer segments can contribute to variation," he said. "Importantly, some institutions may be equipped with specialised equipment or specialist capabilities that may not be routinely available at other centres.' He added: 'As for-profit institutions, private hospitals in Singapore operate independently and serve varied patient segments. In this context, pricing is shaped less by regulation and more by consumer choice – patients can select their providers, and hospitals must remain reasonably price-competitive to sustain demand.'
Yahoo
08-05-2025
- Business
- Yahoo
Medical Billing Market Size to Hit USD 41.32 Billion by 2032, Driven by AI, RCM, and Digital Transformation
The U.S. Medical Billing Market was estimated at USD 4.69 billion in 2023 and is expected to reach USD 12.47 billion by 2032, at a CAGR of 11.50% during the forecast period of 2024-2032. The U.S. dominates the North American medical billing market due to advanced healthcare system and high penetration of outsource billing services. The increasing administrative burden on care providers is also contributing the demand for efficient billing systems nationwide. The medical billing market is witnessing robust growth because of expanding healthcare expenditures, rising demand for electronic healthcare services, and the complexity of coding and billing systems. Trends in revenue cycle management (RCM) solutions and outsourcing are also fueling market growth. Technological innovation and regulatory compliance demands are prompting providers to implement effective billing systems, which are supporting steady growth in hospitals, clinics, and ambulatory surgical centers worldwide. According to SNS Insider, the global medical billing market was valued at USD 15.43 billion in 2023 and is projected to reach USD 41.32 billion by 2032, growing at a CAGR of 11.58% over the forecast period 2024–2032. With an 11.58% CAGR, the global medical billing industry is transforming healthcare finance through automation, cloud adoption, and outsourced revenue cycle management. Story Continues Medical Billing Market Report Scope Report Attributes Details Market Size in 2023 US$ 15.43 billion Market Size by 2032 US$ 41.32 billion CAGR CAGR of 11.58% From 2024 to 2032 Base Year 2023 Forecast Period 2024-2032 Historical Data 2020-2022 Key Regional Coverage North America (US, Canada, Mexico), Europe (Eastern Europe [Poland, Romania, Hungary, Turkey, Rest of Eastern Europe] Western Europe] Germany, France, UK, Italy, Spain, Netherlands, Switzerland, Austria, Rest of Western Europe]), Asia Pacific (China, India, Japan, South Korea, Vietnam, Singapore, Australia, Rest of Asia Pacific), Middle East & Africa (Middle East [UAE, Egypt, Saudi Arabia, Qatar, Rest of Middle East]), Africa [Nigeria, South Africa, Rest of Africa], Latin America (Brazil, Argentina, Colombia Rest of Latin America) Segmentation Insights By Component, Services Segment Dominates the Medical Billing Market In 2023, the services segment dominated the medical billing market by component because the trend of billing processes outsourcing to specialized third-party service providers continues to grow. Physicians, especially small- and medium-sized practices, do not have the experience and resources necessary to handle sophisticated billing and coding requirements in-house. Outsourcing services provide cost savings, decreased administrative burden, and better claims processing accuracy and reimbursement. Regulatory reforms and compliance have also made providers increasingly dependent on seasoned billing service companies, further enhancing the leadership of the segment. By Facility Size, Large-Sized Facilities Segment Dominates the Medical Billing Market In 2023, the large-sized facilities segment led the medical billing market with 46% market share because of their high patient volumes, sophisticated administrative structures, and higher financial capabilities. Large health systems and hospitals have strong billing systems to handle high volumes of claims and maintain regulatory compliance. Their capacity to invest in sophisticated revenue cycle management solutions and implement sophisticated billing software improves efficiency and minimizes errors. In addition, larger institutions will find it easier to implement full end-to-end bill services, further propelling their dominance in the market over smaller clinics and medium-sized health providers. By End User, Hospitals Segment Dominates the Medical Billing Market In 2023, the hospitals segment led the medical billing market with 45% market share because of its large number of admissions, varied services provided, and complexity of the billing process. Hospitals have large-scale billing functions in various departments, and to simplify the process, they require efficient revenue cycle management for timely reimbursement as well as compliance. Their requirement for integrated billing solutions to process insurance claims, patient data, and regulatory requirements is one of the drivers of increased adoption of complex billing systems. Apart from this, hospitals prefer to partner with veteran billing service providers to ease administrative burdens and improve financial results, and further solidify their market leadership. For A Detailed Briefing Session with Our Team of Analysts, Connect with Us Now@ Medical Billing Market Segmentation By Component Software Services Professional Services Managed Services By Facility Size Large-Sized Facilities Medium-Sized Facilities Small-Sized Facilities By End User Ambulatory Surgery Centers Hospitals Specialty Centers Orthopedic Centers Oncology Centers Cardiology Centers Radiology & Imaging Centers Other Specialty Centers Other End Users Regional Market Dynamics North America Dominates the Medical Billing Market, Asia Pacific Expected to Register Fastest Growth North America dominated the medical billing market in 2023 because the region has an advanced healthcare infrastructure, high penetration of electronic health records (EHRs), and strict regulatory environments that demand efficient billing mechanisms. The region is home to large industry players and high outsourcing of billing service providers, thereby adding to market share. Sophistication of U.S. healthcare reimbursement programs like Medicare and Medicaid also creates a demand for advanced billing solutions to process claims efficiently. Asia Pacific is expected to witness the fastest growth in the medical billing market due to increasing healthcare expenditure, increasing digitalization of healthcare systems, and providers' growing awareness of revenue cycle management. Emerging economies such as India and China are investing in healthcare IT infrastructure, which presents great opportunities to expand in the market. In addition, the growing amount of medical tourism and healthcare centers within the region is putting pressure on the necessity for effective and affordable billing services for the processing of higher numbers of patients. Buy a Single-User PDF of Medical Billing Market Analysis & Outlook Report 2024-2032@ Table of Contents – Major Key Points 1. Introduction 2. Executive Summary 3. Research Methodology 4. Market Dynamics Impact Analysis 5. Statistical Insights and Trends Reporting 5.1 Market Growth & Adoption Trends (2023-2032) 5.2 Claim Processing Trends (2023) 5.3 Billing Errors & Denial Rates (2023) 5.4 Technology & Automation Adoption (2023) 5.5 Revenue Distribution & Payer Mix (2023) 6. Competitive Landscape 7. Medical Billing Market by Component 8. Medical Billing Market by Facility Size 9. Medical Billing Market by End User 11. Regional Analysis 12. Company Profiles 13. Use Cases and Best Practices 14. Conclusion Related Reports Healthcare Revenue Cycle Management Market Report Electronic Health Records [EHR] Market Report Healthcare Analytics Market Report Practice Management System Market Report Medical Coding Market Report About Us: SNS Insider is one of the leading market research and consulting agencies that dominates the market research industry globally. Our company's aim is to give clients the knowledge they require in order to function in changing circumstances. In order to give you current, accurate market data, consumer insights, and opinions so that you can make decisions with confidence, we employ a variety of techniques, including surveys, video talks, and focus groups around the world. CONTACT: Contact Us: Jagney Dave - Vice President of Client Engagement Phone: +1-315 636 4242 (US) | +44- 20 3290 5010 (UK)
