There are situations and unfortunate circumstances in life when the choice of hospital is beyond our control. This primarily refers to the (hopefully unlikely) event of a health emergency. However, if you are planning elective surgery or arranging treatment for a specific health condition, it is well worth the effort to ‘shop around’ for a hospital that best addresses your particular needs. If you are using or considering one of the various Medicare supplements in Phoenix AZ, you should also take this factor into account during your search for a good hospital.
Types of hospitals
There are many different types of hospitals, based on funding, size, range of services, patient age etc. In the broadest sense, hospitals can be divided into two main categories – public and private hospitals.
As the name implies, public hospitals are funded by state and federal funds. They are obligated to treat everyone, regardless of their financial status. Public hospitals have long waiting times and offer less personalized care, mainly due to the large patient load.
On the positive side, public hospitals are usually bigger and more affordable. Furthermore, since they have to accept all patients, their medical staff has the opportunity to treat a great variety of conditions (regardless of the symptoms), which significantly adds to their expertise and experience, and hence the ability to handle even the most serious of cases.
Private hospitals are nicer looking and better equipped. The waiting times are much shorter and the staff is usually more attentive. However, these hospitals are more expensive than their public counterparts and often accept only certain types of medical insurance. Although private hospitals reserve the right to refuse treatment on financial grounds, they are still obligated to accept emergency cases.
Non-profit hospitals are founded or operate (or both) under the patronage of charitable, usually religious organizations. In contrast, for-profit hospitals are commercial entities, owned by corporations or individuals.
Safety-net hospitals provide a significant level of charity care to low-income, uninsured and vulnerable populations. These hospitals receive supplemental funding from governmental agencies to offset the under-reimbursed care.
General hospitals treat a broad range of common medical conditions. Specialized hospitals are dedicated to treating specific conditions (cardiovascular, oncological, psychiatric) or specific age groups, such as pediatric hospitals focusing on children care or geriatric hospitals which address the medical needs of the elderly.
Teaching hospitals are best equipped to treat a full range of complex conditions, in terms of staff, technology and subspecialty services. Due to their affiliation with medical schools, patients can benefit from cutting-edge treatments, provided by distinguished, highly-skilled medical experts.
Factors that influence your hospital choice
Your choice of hospital will depend on your healthcare needs, your budget and your healthcare insurance plan. Talking to your doctor about your options is a good place to start. Doctors are uniquely positioned to suggest the best hospitals and specialists for your condition and advise you on the type of hospital you should choose – a specialized hospital, a community hospital, or perhaps an academic medical center involved in research or clinical trials related to your condition.
Keep in mind that your choice of hospital can depend on where your preferred doctor has admitting privileges. Don’t forget to ask your doctor if you will require post-discharge care and where this care can be provided. Also, check the hospital reputation, as it is a good indicator of the quality of staff and services. It’s helpful to know the number of nursing staff in the hospital to make sure you’ll be well taken care of.
Ways to obtain information on hospital quality
In an effort to empower patients and assist them with their healthcare decisions, the Centers for Medicare & Medicaid Services (CMS) periodically release data on the quality of care provided by hospitals, physicians and other healthcare professionals, including patient well-being and updates on the management of specific conditions, such as diabetes and cardiovascular care.
The data also includes updates on HACs (reasonably preventable Hospital-Acquired Conditions, including central line-associated infections, catheter-associated urinary tract infections and pressure ulcers) in the scope of the HAC Reduction Program. In an effort to encourage hospitals to reduce HACs, their performance is rated (1 to 10). The higher the score, the worse the performance.
You can use the browsing tools available on the Medicare website (Medicare.gov) to search and compare hospitals, physicians and other healthcare professionals. Using the hospital compare tool, you can browse over 4000 Medicare-certified hospitals by name, city, state and zip code. You can review information on the quality of care or check the results of patient surveys to see how people rate the services of certain hospitals.
Similarly, you can use the physician compare tool to browse physicians and other healthcare professionals enrolled in Medicare, as well as their primary and secondary specialties.
Medicare supplements in Phoenix AZ and your hospital stay
When planning a hospital stay, it’s essential to know what your insurance covers, so you can avoid unpleasant surprises when the hospital bills come. Here’s what you should check with your provider:
a) if the hospital of your choice is included in your plan’s network,
b) if you need their authorization before you’re admitted and
c) if you are required to choose from a list of approved hospitals or doctors.
One thing to remember is that even if the hospital is in the network, the doctors practicing there may not be part of it.
Beneficiaries of Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) are entitled to the full range of Medicare-covered hospital services. Medicare covers expenses such as semi-private accommodation, meals, nurse services, medications and other essential hospital services and supplies during your inpatient stay.
If you are using Medicare supplemental insurance (Medigap) or Medicare Advantage (an alternative to the traditional Medicare), it will protect you against excessive costs, such as deductibles and copays in cases of accidents or serious illnesses.
Keep in mind that Medigap and Medicare Advantage are mutually exclusive, meaning that you cannot use both, and it is illegal for insurance companies to provide you with both options.