Tips from Hospital Insiders: How to Get the Best Healthcare

Annually, there are nearly 40,000,000 hospitalizations in the United States. Some hospital stays are planned, while others are unexpected. Either way, a hospital visit is less stressful when you have a knowledgeable insider looking out for you. With nearly 100 collective years of direct patient care experience, the team at Better Health Advisors provides our clients with the highest level of personalized guidance and ongoing support. 

Not all health advisors have direct hospital patient care experience, and I believe that puts their clients at a disadvantage. Before launching my own company, I spent over two decades in senior healthcare leadership in New York City hospitals. At BHA, I’ve built a team of carefully selected, talented people with extensive direct patient care experience in a variety of healthcare areas including, medicine, psychology, administration, case management, dietary, and physical therapy. We use this vast and deep expertise to help our clients receive the very best possible medical care. To borrow a phrase from Hamilton, we've been "in the room where it happens.”  

Here’s how to get great healthcare before, during, and after a hospital stay:

1. Don’t be afraid to ask your doctors questions. Communication with your medical team can build trust and alleviate any anxiety about your health condition. It is also important for your medical team to learn about you so that they can provide better results and clarification. 
   

2. Instead of letting insurance drive your care, let your medical team. Your clinical needs are most important. For example, if your healthcare provider recommends daily physical therapy, but your insurance will only cover three days per week, consider paying out of pocket for the additional care. 
   

3. Asking for a second opinion isn’t offensive: Never be afraid to ask for a second opinion when considering your treatment options, because it may help you make a better decision about your care.  Asking for a second opinion will not offend your doctor. Instead, it may change your diagnosis or give you more treatment options. Alternatively, consider asking if a different specialist would have a new perspective on your care. 
   

4. Understand the costs of concierge medicine. Before choosing a concierge doctor, understand all the associated fees. For example, you may pay an annual membership fee upfront, but what other fees do members incur? Find out if your insurance covers your concierge doctor or if you will be responsible for out-of-pocket payments with each visit. 
   

5. Always check if the hospital you are visiting accepts your insurance. Doctors contract with insurance companies and you may be covered under that insurance when you visit their office, but that doesn’t mean you’ll automatically have coverage at a hospital where that doctor is on staff. Call your insurance company ahead of time to confirm that the hospital you are visiting will take your insurance.   
   

6. Home health aide agencies have shift minimums. Often, home aide agencies have minimum and maximum shift requirements. Aides can be on duty in four hour increments, with four hours being the minimum and 12 hours being the maximum. This means that home health aides cannot be hired for small daily assignments; they will be most useful when you need help in four-hour or longer increments. Be mindful of these requirements when organizing home health care for your loved ones. 
   

7. You can stay overnight in the hospital without being admitted. Many hospitals have “observation” beds where they keep patients who need monitoring, but not full inpatient care. This can get tricky for seniors: if you are sent to a nursing home for rehabilitation following your hospital stay, Medicare will only pay if you were admitted to the hospital. Observation doesn’t count.  

8. Take notes during discharge. Leaving the hospital can be disorienting. You may have several next steps, including making appointments and taking medications. Even if you understand the instructions, it is a good idea to leave with a written discharge plan. Information often gets lost during transitions of care, and this can result in medical errors. BHA recommends having a friend, family member, or health advisor present during these transitions.
   

9. Emergency rooms are busiest Monday afternoons. If possible, avoid visiting ERs during this time, or expect to wait a bit longer to be seen. Alternatively, if your condition is less severe, a visit to urgent care might suffice. 
   

10. You will receive two separate hospital bills. You will get one bill from the hospital and another from your doctor. Health advisors can help you understand the financial implications of your care. 
    

11. Your anesthesiologist or ICU doctor might not take your insurance, even if the hospital does. When possible, check with your health insurance company ahead of time to make sure you are covered for surgeries and potential emergencies. 
    

12. You can research safety and quality information online. The federal government created online tools for consumers to compare safety and quality metrics for Medicare-certified hospitals and nursing homes. 
    

13. Private pay is not always accepted. It may seem counterintuitive, but some medical facilities are not equipped to handle private pay and will only accept payment from health insurance companies.
    

14. Requesting the charge nurse can expedite care. A charge nurse supervises a team of nurses and facilitates communication between other healthcare providers. Charge nurses can clarify your questions and improve team communication to expedite your care. 
    

15. ERs are safe even during the COVID-19 pandemic. If you need immediate care or have a medical emergency, don’t let COVID-19 concerns stop you from receiving treatment. Staff in ERs are taking extra precautions to keep patients safe from COVID-19, and they are ready to help you.  
    

16. Know when to call to schedule an appointment. Doctors offices often rely on call centers to schedule their appointments and schedulers receive a higher volume of calls in the morning. If you call in mid-morning or mid-afternoon, you are less likely to be  stuck on hold. 
    

17. In healthcare delivery, team communication allows for better care coordination. Asking for a discussion with your medical team can be beneficial. Talking to your entire medical team at once can illuminate key points in your care plan and reduce the chances of any miscommunication. 
    

18. If you miss open enrollment, you might not be able to enroll in insurance. After missing open enrollment, you can only receive health insurance if you qualify for a Special Enrollment Period due to a life event or you qualify for Medicaid or the Children’s Health Insurance Program (CHIP). 
    

19. Put your health insurance on auto-pay to avoid missed payments. A missed health insurance payment could lead to a cancellation of your plan. By using auto-pay, you may alleviate anxiety around missing a payment and ensure continuation of your benefits. 
    

20. Hospital staff are often overworked, so be sure to express gratitude. Doctors, nurses, and other hospital staff regularly work long, challenging shifts, especially during the COVID-19 pandemic, to care for patients. Being gracious and showing your appreciation for their hard work makes a difference.