Choose the Right Hospital for YouPosted by Medicare Made Clear
If you have a medical emergency, you need to go the nearest hospital for immediate medical attention. But if you know in advance that you’ll need to stay at the hospital for an upcoming surgery or another reason, you should concentrate your efforts on picking a hospital that will give you the best care possible for your needs.
Picking the right hospital will require some research. Start by asking family and friends about their experiences with the hospitals you’re considering. Find out which hospitals your doctor works with and which hospitals he or she thinks give the best care for your condition. If you’re on Medicare, ask if the hospitals participate in Medicare.
Know What Your Insurance Covers
While some out-of-pocket expenses are to be expected, there’s a lot you can do to prevent unnecessary hospital costs. Call your insurance company for the following information.
- Which hospitals are in your plan’s network. Be aware that even if a hospital is in the network, doctors who practice there may not be.
- The difference between in-network and out-of-network costs, such as deductibles or coinsurance.
- Whether your procedure requires pre-authorization.
- See how much Medicare paid hospitals for certain conditions and procedures.
Consider the Doctor
You’ll want to find a good doctor. Your choice of hospital may depend on where your physician or surgeon has admitting privileges.
- Ask your primary-care doctor to recommend a specialist from the list of doctors approved by your insurance company.
- Ask the specialist about his or her experience. For example, if you are seeking a surgeon, ask about the individual’s surgical results and how many operations of the type you need he or she has performed. This is especially important if you need specialized surgery, such as neurosurgery.
There’s a lot of information today to help you find a good hospital in your area. Consumer Reports suggests you check hospital ratings based on patient experience, patient outcomes, hospital practices and safety scores. You should:
- See how often a hospital gives the right treatments for certain conditions like heart attacks, heart failure and pneumonia; or procedures like preventing surgical infections.
- View the results of care or treatment for certain conditions or procedures.
- Learn whether the hospital offers certified programs, such as stroke care.
- Get data on the hospital’s National Quality Improvement Goals. This tells you about the quality of care for several specific conditions, including children’s asthma, heart attack and heart failure, pneumonia, pregnancy, and preventing surgical infections.
Some hospitals simply do a better job than others. Hospitals that do a greater number of the same surgeries have better outcomes for their patients. So do the research and choose the best quality hospital that fits your needs.
For more information, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.
How to Choose a Hospital: Watch a video telling you what to look for when choosing a hospital
Choosing a Hospital worksheet: Agency for Healthcare Research and Quality (AHRQ.gov)
Hospital Compare: Find hospitals in your area and compare their services—Medicare.gov