When you need surgery, there are a lot of things to consider. Choosing the best hospital is one of them. If you live in an urban area, you may have several hospitals to choose from. If you live somewhere more rural, your options may be limited. But even if you have to travel to a different city or a state for surgery, which hospital you go to can make a big difference in your overall experience.
Keep reading for information on which questions you should ask when choosing a hospital to have your surgery at.
How good are the outcomes at the hospital?
Most hospitals in the United States are rated by the Centers for Medicare and Medicaid Services (CMS) based on how well they are able to provide high-quality healthcare. In order to determine this, there are several quality measures used. These include things like complications from surgery, readmission rates, mortality (death) rates, and the number of patients who are injured (from falling, etc.) or who receive the wrong medicine. This is not an all-inclusive list of quality measures, but gives you a good idea of the type of things CMS looks for when rating a hospital.
In addition to the government, many non-profit organizations and even some news publications score and rank hospitals according to the quality of surgical results. These scores and rankings can help you decide whether the hospital you are considering is safe and will deliver a successful surgical outcome. To find out the ratings of hospitals near you, you can use several tools, including:
- Consumer Reports Hospital Ratings
- Medicare.gov Hospital Compare Tool
- US News and World Report’s Hospital Ranking
- Pro Publica’s Hospital and Surgeon Scorecard
Is the hospital is in- or out-of-network?
You may have heard the terms in-network and out-of-network. These phrases are used to identify which insurance plans a hospital, clinic, or individual doctor is contracted with. If a hospital is “in-network” they have negotiated a discounted rate with your insurance company, meaning you will end up paying less out of pocket. If a hospital is “out-of-network” they have not negotiated a rate with your insurance company, and you will end up paying much more out of pocket. Typically, your insurance plan will have higher deductibles and higher coinsurance for out-of-network hospitals. (“Deductible” means you will have to pay a certain amount out of pocket before your insurance kicks in; “Coinsurance” means your insurance will cover less than 100% of the bill, regardless of what your deductible is)
If you use your Carrum Health Surgery Benefit to pay for the surgery, you will NOT need to worry about these things. In fact, with our hospitals, you will have zero out-of-pocket costs and no surprise bills so you can focus on getting better. (Note that if you have a particular kind of high-deductible health plan, the IRS may require that you meet your deductible first.)
Does your surgeon have admitting privileges at the hospital you are considering?
Another thing to consider when choosing a hospital to have surgery at is if the surgeon you have chosen has admitting privileges. This simply means that the surgeon is a member of the hospital’s medical staff and has the ability to admit you to that facility for surgery. When you are interviewing surgeons, be sure to ask for a list of hospitals they can admit you to — this could make a big difference in which surgeon and which hospital you will be able to use.
If you have not chosen a surgeon yet, check out our post on how to choose the right one for you.
Is the hospital accredited by The Joint Commission?
The Joint Commission is an independent, not-for-profit organization that provides accreditations to hospitals and other healthcare organizations in the U.S. If a hospital has been accredited by The Joint Commission, it means they have passed a set of standards and are considered a high-quality healthcare organization. You can use their search feature to find out if the hospital you are considering is accredited.
How is the hospital rated by state agencies or non-profits?
While The Joint Commission and CMS provide reliable ratings for hospitals, it cannot hurt to seek out additional reviews. Sometimes states require hospitals to report information to them (such as mortality rates) and may publish reports that compare different hospitals in their respective states. For example, in California, a state-wide multi-stakeholder group operates Cal Hospital Compare and the Department of Public Health maintains a database of hospital incidents and complaints.
Additionally, your insurance company may have comparisons on hospitals available for you to peruse. Be sure to ask.
Finally, Carrum Health only uses the highest rated surgeons and hospitals, so if you are signing up for your surgery through us, you can rest easy knowing you will have the best experience possible.
How do other patients feel about their experience at the hospital?
All of the standards and reviews in the world do not mean much if the patients at a hospital do not feel safe, valued, and respected. You can find personal reviews for hospitals on sites like Yelp or Healthgrades. You can even ask the hospital if there are patients you can speak to — most will be happy to offer this when possible.
How do you feel about the hospital?
Before you make your final decision, it is a good idea to visit the hospitals you are considering. You can schedule an appointment for a tour or you can walk in and see how you feel. How are you treated by the staff? Are they helpful? Do you feel confident in their ability to answer any questions you have? These are all important factors to weigh when you are making your decision.
When you need to have surgery, choosing a hospital is just one of many decisions you will make. While there are a lot of factors to consider, picking the right hospital for the procedure you need does not have to be hard. You can use these questions to help guide your decision-making process. If your employer offers Carrum Health as a surgery benefit, your Carrum Concierge will be able to help you at every step of your surgery journey.