Why Choosing a Hospice Provider Matters

wheelchair and aide

A headline in the business section of the Atlanta Journal several weeks ago caught my eye: “Atlanta hospice to pay $3 million.” That’s a lot of cash. The article went on.

“A Georgia hospice company has agreed to pay $3 million to resolve allegations it billed taxpayers for patients who were not terminally ill, the latest such settlement as federal officials target what they call a burgeoning number of abusive hospice schemes.” (italics mine)

There’s no question how important hospice care can be for someone to live their last days fully, surrounded by their loved ones and personal belongings, and supported with the physical, social, and spiritual services that underpin hospice care. read more

Patient-centered care – you may need a buddy!

Buddies

A friend of mine was undergoing an outpatient surgery a few weeks ago. Once in a gown, and her IV started (not a power position for us as patients, by the way!) her surgeon stopped in before heading to the OR to scrub. Having already talked with the anesthesiologist, my friend also shared her concern with her surgeon that she has had really severe nausea with codeine-based pain relievers after surgery (I mean really awful – I’ve been there!) with me nodding along vigorously and asked for different post-op medication. Her young-ish (to us, anyway!) surgeon was patient and gracious in responding that all narcotic pain relievers cause stomach upset and she would provide an anti-nausea medication to take along with the codeine-based drug she preferred to prescribe. Before my friend could share that that she’d had anti-nausea medication before and it wasn’t particularly effective, the surgeon exited stage left to prep for surgery. read more

Does Insurance Cover That?

insurance

Inevitably when I’m asked what I do and respond that I’m a private patient advocate, one eyebrow raises, followed by “What’s that?”

My “Private Patient Advocate” elevator speech goes something like this:

“Private patient advocates are independent professionals that help patients and their families clarify options for managing their healthcare as well as the cost of their care. This might mean things like sourcing a doctor for a second opinion, facilitating better coordinated care, researching nursing homes, or negotiating insurance claims and medical bills.” read more

Before you jump in…Re-thinking preventive health screening

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An advertisement arrived in my mail recently from a local hospital system offering a special promotion on  “heart disease, stroke, and aneurysm prevention package testing.” The tests included were extensive, and the mailing screamed not to wait to schedule these “life-saving screenings.” And, by the way, these tests are normally valued at over $2100 but were offered through this promotion for the low, low price of $179.00! My doctor has never mentioned most of these tests to me, but I found myself wondering about the state of my arteries and heart and whether having these tests might not be a good idea. read more

Caveat Emptor! (Or…a new twist in paying for healthcare)

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Monica* had driven herself to the emergency room at a local hospital late at night after experiencing severe abdominal pain. She was worried she might have appendicitis, and her insurance company nurse line had advised her to go to the emergency room. A CT scan, MRI, and blood work were ordered, and intravenous pain medication was started. After several hours, her tests showed that she had a ruptured ovarian cyst, not appendicitis, and she was discharged home.

So here’s the “gotcha” moment, a new twist in paying for healthcare. When Monica was checking out, the clerk asked if she’d like to pay cash for her visit for a 75% discount, or to have the hospital file the visit to her insurance. Her insurance deductible was $2500 and she hadn’t had any healthcare costs yet this year. read more

Location, Location, Location!

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Why *Where* you Get Your Health Care Matters to Your Pocketbook

That old saying about real estate value is true in health care, too.

I had the mistaken idea some years ago that if my doctor ordered an MRI, the cost was the same wherever I had it done. I only paid a copay, so why did it matter?

It actually does matter especially since insurance coverage has changed.  More and more policies demand higher patient higher deductibles, as well as coinsurance, or a share of the costs rather than a flat copay.

I recently did research for a patient whose doctor had ordered X-rays and an MRI which were important to developing a treatment plan for a complex condition. Her insurance coverage required she pay 20% of the allowed charges (what the insurance company had contracted with the  provider to pay for the studies), and she was concerned how much it might be. read more