The Importance of Choosing the Right Medical Provider

Choosing the right medical provider to perform a surgery with the best possible results is a tricky thing. The typical free market rules of quality versus price rarely apply in healthcare. Getting a hip replacement is not like buying a washing machine, where the expectations are that with increasing price, the quality will go up as well. As a matter of fact, medical costs mostly develop in reverse manner – the poorer the quality, the higher the risk of adverse effects, infections, prolonged downtime and potential readmissions, all of which lead to soaring medical bills the patient never expected. Ultimately, poor decisions while choosing a medical provider often result in a patient’s complete loss of control over healthcare costs. [1]

The problem with choosing the right medical provider is that overall quality of medical care can be a bit misleading at times. In fact, the same hospital can have stellar success rates in one medical area, but not-so-great results in another medical area. The general evaluation of hospital care can still be above average, but the reality is that the specific medical problem a patient is trying to solve with a surgical procedure does matter a great deal. Let’s say, for instance, that a patient lives in an area where the local hospital is an excellent choice when the patient is in need of a joint replacement. However, the same provider would be a suboptimal choice when facing problems with veins and arteries as its quality ranking in vascular surgery is fairly low. [2] In simple terms, some medical providers will have excellent scores in one area and worse results in another, and it is necessary for a patient to consider these discrepancies instead of looking at “the bigger picture”.

One of the greatest advantages that BridgeHealth brings to the table is its extensive experience with negotiating bundled prices for surgical procedures as well as their network of medical providers within the High Performance Surgery Network. Not only does BridgeHealth use medical providers among the 25% highest ranking hospitals in the country, but BridgeHealth professionals are also able to accommodate clients based on their specific needs and negotiate bundled prices with medical providers that would be the most suitable for them. With the help of the Comparion CareChex Hospital Quality Rating tool, BridgeHealth is able to select medical providers based on various quality measurement categories, such as mortality, complications, patient safety, patient satisfaction, etc., as well as clinical categories, such as overall hospital care, overall medical care, overall surgical care, hip fracture repair, joint replacement, and many others. This way the patient can be assured that the medical provider selected to perform a surgical procedure in question is not only one of the best in general, but it is also the best one in the medical area relevant to his or her specific health issue.

Choosing the best healthcare provider provides an excellent opportunity to eliminate the undesirable side-effects associated with surgical procedures, namely complications and hospital readmissions. Together with pre-negotiated bundled pricing, BridgeHealth offers an optimal solution for patients and their employers which can cut patient recovery time, give them more predictability over their medical costs, and save significant amounts of money.

1) Who Pays for Poor Surgical Quality? Building a Business Case for Quality Improvement,  http://www.researchgate.net/publication/7048053_Who_Pays_for_Poor_Surgical_Quality_Building_a_Business_Case_for_Quality_Improvement

2) Hospital Quality Ratings 2016, CareChex, http://www.carechex.com/Default.aspx

Share this post