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Financing for Healthcare Done by Jeffrey (Financial Counselling (key steps…
Financing for Healthcare Done by Jeffrey
Low mortality rate of 2.0
2nd lowest in the world
better living conditions
good healthcare services provided
Challenges faced
Increasing aging population which known as Silver Tsunami
Bed crunch in healthcare facilities
High demand for beds in public
hospitals
90% bed occupancy
more hospital re-admissions
Better access to medical
treatment
Better hygiene conditions
Lead to decline of infectious
diseases
Singapore Government spending of healthcare increased
Shrinking workforce
Long life expectancy
More demand for healthcare manpower
Conflict: Unequal distribution of doctors
(private and public sectors)
People prefer to work in private than public
Public doctors: more
overworked and/or underpaid
Lack of manpower
Acute care,
Intermediate and longterm
care
Medical staff
Undesirable working
conditions
Leading them to:
Work-life imbalance
Low level of job satisfaction
Low motivation
Long working hours
Heavy case load
Underpaid compared to the
amount of work they do
insufficient places in
medical schools
Nursing and allied health staff
High number of elderly,
low number of staff
Shift work
Not wanting to work on public
holidays and weekends
Low career-advancement prospects
and scholarships
New and complex conditions
Harder to cure
Require even more advanced
technology
R&D (Research and Development) need to
do more tests and come out with cures for
such conditions
Focused on:
Ensure access to good
and affordable
healthcare
Multiple layer protection system
based on:
Individual responsibility
working and earning an income
accumulate Medisave amount
Co-payment
Healthcare financing
Government subsidies
Heavy subsidies of up to 80% in
public hospitals as well as
polyclinics
subsidised clinics and wards (C class
ward)
eg. CHAS, PGP (Pioneer
Generation Package)
The 3Ms: providing universal
medical coverage for all
Singaporeans
Medisave
Compulsory health savings
Help patients for co-payment
Earned through salary
Can be transferred from one
family member to another
Used for: surgery, giving birth,
chronic MediShield Life diseases and ILTC
Medisave For Under 21
Coverage for vaccinations such as HPV, Hepatitis B, Influenza
Available for GPs, Polyclinics, SOCS (per account about $400)
Newborn screening test
1 more item...
Medical / Surgical Inpatient cases; $450 for daily hospital charges and $50 for doctors daily attendance
Rehabilitation mobility hospitalization
Inpatient
1 more item...
Outpatient
1 more item...
Approve day surgery
$300 daily hospital
$30 daily's daily
Surgical operations (inpatient and day surgery)
1 more item...
For couples who are conceiving
$4000 (Third Time)
$6000 (First Time) Yay!
$5000 (Second Time)
Pre-Delivery
1 more item...
Delivery Charges
1 more item...
Hospital Charges
1 more item...
Medisave grant for newborns
$4000
CPF Medisave Account
In Jan 2015
1 more item...
Medifund
an endowment fund
serve as a safety net
for those who still require help with
paying medical bills even after making
use of Medisave, MediShield Life,
government subsidies as well as cash
The interest income generated from capital
sum: utilised, providing financial assistance
for healthcare bills
Applying for MF
PAYSlip, IC, CPF statement, Bank Statement, Household expense, Medical bills
MediShield Life
Voluntary, low-cost health
insurance system
previously known as
MediShield
Pay for large bills, selected
outpatient treatments
Coverage pre exisiting condition
Medishield life
Protection for life
Coverage for B2/C and Public hospitals
Prem can be paid by medisave
Addidtion private insurance coverage
NTUC, Great Eastern, Prudential
Withdrawal limit below 40 is $500, 41-70 is $600, 71 above is $900
Hospital coverage after 365 days
Renewal of plan
No medical underwriting
Outpatient treatments
SG/PR also can use
Comprehensive, integrated
system of public and private
healthcare facilities
Acute, intermediate and
primary care sectors
Upcoming: Three-Cluster System
Central region: National Healthcare Group (NGH); Eastern
region: Singapore Health Services (SingHealth); Western
region: National University Health System (NUS)
Why re-cluster?
Need to transform care models, emphasising
population health, preventive care and truly
integrated health system
More integrated and better quality healthcare services
provided through closer cooperation and resource
sharing
Something essential to improve and transform
Singapore's healthcare system
An integration across healthcare as well as
community services, focusing on health and
healthcare
Easier to strategise and implement decisions across various
institutions
New entities can tap the combined
strengths of the original clusters
Each will have:
Fuller range of facilities, capabilities,
services and networks across various care
settings
To serve the needs of the
population by:
Allow patients to flow seamlessly through care providers- achieve
best outcomes
allowing patients to have continued care, according
to their needs after discharge from acute hospitals
Prevent patients from getting lost
as they move through the system
Enable patients to be cared at
most appropriate care setting
Healthcare system benefits?
System is efficient: better use
and allocation of resources
(manpower and cost)
Better patient outcomes-less
complaints
Public hospitals supported by:
Intermediate and long-term (community
hospitals, nursing homes, day care,
home-based services)
Primary (polyclinics, GPs)
Receive subsidised healthcare
Polyclinics all over the island
Result:
An integrated system
Supports Singapore's vision: One family physician for every
Singaporean
Promoting good
health, reducing
illness
SG healthcare
management
Build healthy
population
With the help of preventive
healthcare programs and
promoting healthy lifestyle
Health promoting
organisations: Health
Promotion Board (HPB)
Leading national agency
Advocate healthy lifestyle and driving various
national health promotion and illness
prevention programs
Focus on preventing illness
by: keeping healthy lifestyle
Ministry of Health
(MOH)
Ageing Planning Office
Educate the public
Ensures that there are sufficient
resources to help control and prevent
diseases
Sliver Industry Standards
Committee (SISC)
Collaborate with HPB to promote
healthy ageing for elderly
programs
Guidelines on Nutrition
and Food Service for
Older Adults
Scope
Outlines provision and food preparation for older adults
Covers obligations and roles, nutritional care
policy, quality practices, procurement, menu
planning, food services and selection
Why need this standard?
Meeting the increasing needs of ILTC
facilities and community-based services
Provide guidance on the nutrition
and health of older adults
Safe and adequate food are served to
meet the nutritional needs of older adults
The Users
Operators of
institutional/residential and
non-residential care facilities
and services
Food services providers that cater food to
institutional/residential and non-residential
care facilities
Lead to a healthy workforce
and the healthiest young
population
Increased work productivity
Allow healthcare professionals
to simplify or automate
processes to deliver quality
care
Pursuing medical
excellence
Improve healthcare by:
Invest in biomedical
research
Supporting clinical trials
Working with various international
partners
Various innovations
Product innovation
Introduction of new type of
good and service for the
external market
Process innovation
Enhancement of internal
production processes for
goods and services
Healthcare innovation
Introduction of a new concept, service, process, or
product aimed at improving treatment, diagnosis,
education, prevention and research and with the long
term goal of improving quality, safety, outcomes,
efficiency and costs
Informatics Technology
electronic Clinical
Health Record (eCHR)
Enable physicians and other healthcare
providers to securely access healthcare
information collated from any number of trusted
sources relating to an individual patient in a
structured and easily accessible way
electronic Personal Health
Record (ePHR)
Allow users to check their key medical
records and appointments from public
healthcare institutions
Singapore's first one-stop online health
information and services portal and mobile
information
record and selectively share
healthcare information about
themselves and their loved ones in a
secure manner
HealthHub: initiative by MOH and HPB
Increase health literacy
Encourage adoption of healthy habits
Nudge Singaporeans to take greater
ownership of their own health and
wellness
Integrated health
IT help to keep costs
affordable
Save time
Lower incidence of
medical errors
Reduce
administrative errors
Better practices and
greater patient safety
Enforce better
prescribing practices
with peer reviews
Reduce human errors
related to handwritten
records
Takes guesswork out from
lack of past records
Prevent duplicate and
unnecessary tests and
adverse drug events
Better clinical care
and streamlined
workflows
Support clinical decision
making and workflows
Enables greater patient
participation and supports self help
Enable providers involved
in patient care journey as a
team
Seamless transition of patient
into different care settings
Better manage chronic illnesses
healthcare
informatics platform
enable all healthcare data to
be stored and accessed via
the ePHR and eCHR
solutions
Consist of the following:
High quality and standards
Safe and trusted
Accessible and affordable
Healthcare system's goals and objective
Must challenge to meet the growing needs and expectations the people
Priority: Having a Healthy Singapore
Everyone can have access to high quality and affordable healthcare
World class healthcare system
founded on quality of medical education
The first medical school is Yong Loo Lin School of Medicine
Steadfast in providing well trained doctors with well-renowned teaching
Another medical school is New DUKE-NUS; graduate medical school
Allow graduates passionate about medicine to become a physician scientists
Build a national system to share medial records
One Singapore, One Health Record
NEHR (National Electronic Health Record)
The Key enabler of Singapore's Strategic vision
Integrated healthcare centered on each person
Extracts and consolidates in one record, all clinically relevant information from their encounters across the healthcare system throughout one's life
Support integrated care across care settings and providers in Singapore, made by seamless exchange of health information via Information Technology
Secure "real-time" access to patient
health records by authorised clinicians
and healthcare providers
Enable greater coordination
and informed decision-making
Resulting in more accurate diagnosis,
better treatment and patient-centric
integrated care
Long life expectancy of 81.0
9th highest in the world
more advanced technology
increasing aging population
Financial Counselling
When patients are unable to pay for their medical bill
Tell patients how much they are expected to pay (estimated amount)
To counsel patient on the financial impact of their medical treatment
it is mandatory under the private hospitals and medical clinics regulations for all hospitals to provide financial counselling to their patients prior to or upon admission.
Save the patient from financial burden
When is being performed?
For patients admitted to the Emergency Department (Second Fc should be made within 48 hours of admission.
Rationale being the diagnosis and/or treatment that the patient may require at the point of admission may still be uncertain
Means testing framework
The current means testing framework impedes free movement of patients within and without clusters because of the complexity and difficulties of household mean testing versus individual mean testing.
A patient will resist admission to a community hospital or ILTC sector if his or her entire household must be subjected to mean testing.
Admission to acute sector is far less complex as only the patient will be means tested.
Can online sign be used?
Yes, but the document and signature must be fused together
key steps and considerations in financial counselling
See if they have the capability to pay for the bills so that they will be able to decide whether to proceed with the treatment or should not.
Mean testing is required to determine the amount of government subsidies patient is entitled to.
Choice of class and depends whether they want to upgrade or downgrade the ward class
Use of paper Means Test Declaration Form - Capture signature, serial number for MOHs record and tracking
Patients signs Admission/eFinancial Counselling Form - Have the acknowledgement from the patient.
Let NOK know so that if patient is ever in a situation where they aren’t able to make any decisions, NOK has attorney to make.
Obtain authorisation from patient so that staff can use patient’s information in an appropriate manner.