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Healthgrades Advisor Shares Tips on Choosing a Plan

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Healthgrades Advisor Shares Tips on Choosing a Plan

Like many people, you probably have attempted to look up the healthcare.gov website to apply for affordable health insurance. Unfortunately, like many, you probably have experienced technical glitches while perusing the site.

So what should you do while waiting for the website to be fixed? Twiddle your thumbs? Absolutely not! There is still plenty of healthcare shopping that consumers can do while waiting for the site to be repaired.

While shopping for healthcare, people should remember that choosing a plan is not just about cost, but about the quality of care received. Consumers must make the right decisions on picking the right doctor affiliated with a high quality hospital in their new plan. This is important in saving their life and avoiding unnecessary complications.

Archelle Georgiou, M.D., a strategic advisor to Healthgrades, a former Chief Medical Officer of United-Healthcare, talked to Brandi Walker about what Americans must know when choosing a plan and the key findings in Healthgrades new report.

  1. What are the most important things to consider when selecting a health plan? Before selecting a health plan, there are some important things to take into consideration: 1. Determine Your Healthcare Needs- Think about what types of care you will need over the course of the next year and be realistic. Are you and your family relatively healthy and visit the doctor for preventive care? Or do you or one of your family members have a chronic condition that requires regular follow-up appointments, prescription medication, or specialty care? Perhaps you and your family are healthy, but you anticipate needing elective surgery. 2. Pick Your Providers Before You Pick Your Plan- Since your insurance plan determines the network that you can see, pick your providers before your plan. Talk to your family and friends for recommendations, then research the doctors’ experience and credentials. And, since quality matters and not all hospitals perform equally, make sure your doctor has admitting privileges at a hospital recognized for quality performance in areas that are relevant to your care needs. Considering both quality and cost will lead you to the right provider and plan for your particular needs. 3. Review Your Insurance Plan Options- If you are shopping for insurance through the Exchanges, you’ll see four categories of options named after metals: bronze, silver, gold and platinum. Bronze plans will generally have the lowest monthly premiums but have higher deductibles, co-payments and co-insurance compared to platinum plans. Employer-based plans also differ by premium and out-of-pocket costs. Be sure to look at more than the monthly premium so that you understand the total cost you are likely to pay for insurance.
  2. What are the key findings in Healthgrades American Hospital Quality Outcomes 2014: Report to the Nation? Healthgrades report reveals that there is wild variation in quality across the nations’ 4500 hospitals. By measuring mortality and complication rates for 31 common procedures and conditions, the report shows that if all hospitals performed as well as the highest rated hospitals, we could have saved 234,252 lives and prevent almost 157,418 complications. In addition, lower quality care can actually cost more, and for the conditions analyzed in the report, complications nearly double the cost of a hospital stay. For example, a gallbladder operation without complications may cost $20,000, but with complications it can cost up to $46,000. The bottom line is that quality matters and Healthgrades makes all of this information and more available, for free, on Healthgrades.com so that consumers can choose the hospital and physician in their community where they’re likely to receive the highest quality of care with the best outcomes.
  3. There are so many ratings sites for doctors and hospitals. What’s the difference between them and how do you pick one that is credible? The difference between ratings sites can be the source of data used to evaluate hospitals. Some sites base their information on surveys and reputation. Others tabulate the perception and experience of patients. The ratings on Healthgrades.com leave perception and reputation out of the equation and instead, use objective performance measures to determining ratings: safety, complications, and mortality.

For more information on the new Hospital Quality report, visit www.healthgrades.com.

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