5 ways to choose the best hospital
We go to the hospital for care when we’re the most vulnerable, so we want to pick the best one we can. But how can the average person make a good choice? Our expert suggests five things to consider:
“Let’s face it, one of the most important factors anyone will consider when choosing a hospital is cost,” says Paula Krier, an area chair of the health administration program for the University of Phoenix College of Natural Sciences at the Southern Colorado Campus.
“Whenever I’ve chosen a hospital, I’ve always looked at which facilities were covered by my insurance first, then [I’ve] gone from there.”
Krier recommends that consumers take the time to go over their benefits, network coverage and out-of-pocket costs for various facilities, and check factors such as care philosophy and location. “Not everyone can afford to travel out of state to a premier facility like the Mayo Clinic,” she says.
2. Insurance ratings
Once you’ve determined what’s covered, see if your health plan also rates facilities and provides that information to its members. “Most major health insurance companies offer some sort of internal quality rating system,” Krier notes.
Chances are your insurer posts quality ratings for hospitals and individual providers on its website or via publications available to policyholders. “Insurance companies don’t want to pay for poor-quality care because it results in expensive complications, so they do track whether hospitals do a good job at meeting patient care standards,” Krier explains.
3. Publicly available rankings
Many consumer-focused hospital ranking systems are also available to the public. Options include the Leapfrog Group, U.S. News & World Report, Consumer Reports and customer-rating sites like Angie’s List. You might have to pay a subscription or membership fee for access to some of this information.
“Take some of these ratings systems with a grain of salt,” Krier cautions. “Just because a hospital isn’t ranked in the top 10 in the country doesn’t mean it’s not a good hospital for routine care. And look for an overall ratings trend rather than just one rating.”
With the passage of the Affordable Care Act, the U.S. Department of Health and Human Services also rates hospitals based on rigorous criteria, and its information is free.
As with any type of customer service, you can learn a lot by talking to family and friends about their experiences at a particular hospital, Krier says.
She warns, though, that if none of your preferred doctors have admitting privileges at the hospital you are evaluating, or your health plan suddenly drops coverage of a certain facility, “that’s a major red flag.”
If you have the option of checking out a hospital and interviewing its staff ahead of time, do so. “Take a look around,” Krier advises. “Is the facility clean? Are there enough nurses? Is there a patient care coordinator? All of these things can tell you about a hospital’s quality.”