Bottom Line Inc

Is It Time for a New Hospital?

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Until recently, if you were hospitalized, odds are you would end up in a room with other patients. When you left, you might—or might not—get a discharge plan for the care you needed at home. And the only follow-up you got was a bill!

Now all that is changing. These days, one-third of doctors are employed by hospitals, which are aggressively marketing their physicians and upgraded medical facilities directly to patients. Hospitals are also focusing more on getting people well while they are hospitalized—and keeping them well after discharge—due to financial incentives and penalties associated with insurance reimbursement. To take advantage of these changes…

• Ask for a private room. Most hospitals are now either building new facilities with only single-bed rooms or converting many of their existing rooms to single beds. In a private room, you’ll have a lower risk for infection and you’ll get peace and quiet. However, private rooms may cost you extra—at least $100 more per night. Private rooms are covered by all insurance plans, including Medicare and Medicaid, if there are no multi-bed rooms available or your doctor deems a single-bed room “medically necessary” (which means your recovery or care is at risk in a multi-bed room). Action step: Check the hospital(s) where your doctor has privileges to see if it charges extra for private rooms. If that hospital does charge extra, then ask your doctor whether he/she considers a private room medically necessary for you.

• Get thorough discharge plans. Health insurers are now reducing hospital payments if you are readmitted within 30 days after your discharge. As a result, most hospitals are trying to provide patients with more and better information about what they need to do to stay well when they get home. Action steps: Check with your assigned discharge planner (usually a nurse or social worker) to make sure you get a list of the medications you need to take once you’re home, and ask the hospital to call your pharmacy to order those drugs before you leave. Also, ask for a list of phone numbers where you can reach hospital personnel 24 hours a day if you have a problem once you’re home. If you need at-home care, make sure the hospital orders it—and any equipment you may need such as oxygen or a walker—before you are discharged. And insist that you be given instruction on any special care you may need to administer yourself, such as injections, bandages or insulin pumps.   

• Use follow-up services. Besides buying up private doctors’ practices, hospitals are also buying up many formerly independent medical services, such as agencies that provide home care and physical therapy and occupational therapy. Some hospitals even have contractual arrangements with in-store drugstore-owned clinics such as those found at CVS, Walgreens or Rite Aid stores for routine posthospital monitoring of incision sites, blood pressure, etc. While you should choose the service providers you prefer, it’s often wise to consider using ones that are affiliated with your hospital to help ensure the continuity of your care (they typically have access to all your records and easy communication with the hospital). Action step: If possible, find out before your hospital stay what follow-up services you will need and what providers are affiliated with the hospital so you can check them out in advance and request a particular provider(s) you may like and/or find convenient.

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Source: Charles B. Inlander, a consumer advocate and health-care consultant based in Fogelsville, Pennsylvania. He was the founding president of the nonprofit People’s Medical Society, a consumer advocacy organization credited with key improvements in the quality of US health care in the 1980s and 1990s, and is the author or coauthor of more than 20 consumer-health books. Date: February 1, 2016 Publication: Bottom Line Health
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