Government committee to be set up to look into management of Integrated Shield Plans, panel doctors

SINGAPORE: Health Minister Gan Kim Yong will appoint a committee to look into matters related to Integrated Shield Plans (IP), including the issue surrounding insurers' panel doctors.

In a Facebook post on Saturday (Apr 3), Senior Minister of State for Health Koh Poh Koon said that he met representatives from the Singapore Medical Association (SMA), Life Insurance Association (LIA) and the Academy of Medicine, Singapore on Wednesday to discuss improvements to the way IP panels are set up and administered.

All parties agreed to formalise an existing pro-tem committee into a committee appointed by Mr Gan. 

"The committee will take the work forward, and work in the public’s and patients’ interest to deliberate and implement changes for quality, safe, cost-effective and affordable care for all," said Dr Koh.

DOCTORS, INSURERS "SPARRED" OVER IP PANELS

Doctors and insurers have "sparred" recently over the issue of IP panels, noted Dr Koh. 

Integrated Shield Plans comprise two parts - a MediShield Life component managed by the Central Provident Fund Board, and additional benefits offered by private insurers.

In a position statement on Mar 29, SMA said that insurers had formed "highly exclusive" medical panels that excluded many private specialists.

SMA also said there is "opacity" in the selection criteria for doctors to be included as preferred providers in panels.

The association also called on the authorities to "instil cost discipline in IP insurers" and ensure that premiums collected are directed to healthcare costs and "not frittered away on non-healthcare cost items".

In response, LIA, which represents insurers, said there were cases of "over treatment" by medical providers. It also said SMA’s analysis of insurers’ costs and claims costs are "misleading".

In a later statement on Apr 2, LIA said that insurers have since expanded their panels and will continue to do so, with current IP panels ranging from 250 to 400 private specialists.

On Saturday, Dr Koh said: "Both sides have made valid points on areas that needed to be improved but have also expressed views that are not correctly reflecting the trade-offs and balance needed to ensure sustainability of the premium of insurance plans and the provision of cost-effective quality healthcare in the longer term."

He added that his discussions with all parties were "constructive" as they considered ways to work together for the benefit of patients.

"These include expanding insurers’ panel of doctors with clear and transparent criteria, as well as improving the claims pre-authorisation process for treatment, particularly by doctors who were not on panels," said Dr Koh.

There were also several ideas on improving transparency on doctors’ fees and outcomes, as well as insurers’ performance.

More details on the committee and its proposed recommendations will be released when ready, said Dr Koh.