Selecting a Top-Quality Provider is More Important Than Ever

It’s wise to always choose a medical provider that will provide the best results. Enlisting a top-rated provider will save patients time and, perhaps surprisingly, money. With the cost of healthcare as high as it is, one might assume that this also means the quality of the healthcare is also high. However, this commonly isn’t the case. A large amount of medical expense is not necessarily proportionate to the quality of care that will be received.

For instance, consider hospital readmission rates. According to quality-reporting initiatives from the Center for Healthcare Quality and Payment Reform, 15-25% of people who are discharged from the hospital will be readmitted to the hospital within 30 days or less, and many of these readmissions are preventable [1]. Due to complications and subsequent readmission to the hospital, the cost of care therefore increases significantly.

Hospital readmission rates and efforts to decrease them has become a hot topic in 2016. Modern Healthcare reports that most hospitals are now facing a 30-day readmissions penalty. Of the more than 3,400 hospitals that are subject to Hospital Readmissions Reduction Program, only 799 performed at the appropriate levels to avoid penalties [2].

Results from an analysis published by Harvard Business Review indicates that efforts to improve patient communication paired with a high-quality process-of-care could have a strong impact of reducing readmission rates [3]. Research shows that there is a convincing correlation between a healthcare provider’s communication skills and their patients’ capacity to fully implement recommendations for care given by the provider [4]. This research supports the idea that communication is paramount to high-quality healthcare. In the instance of a surgical procedure, unclear post-operative instructions or an otherwise poorly managed hospital discharge decreases the level of quality care and increases the chance of readmission, costing the patient even more in the end.

BridgeHealth has created a network of Centers of Excellence that provides Plan Members with access to a network of top-rated providers. Using industry-recognized standards, we have identified and cultivated partnerships with surgical providers that rank in the top 25% nationally [5]. Because BridgeHealth believes high quality care should be affordable, we’ve also worked with our network of providers to provide bundled case rates, meaning little to no out-of-pocket expense for Plan Members. BridgeHealth’s offering benefits Plan Members and Plan Sponsors alike through improved care and outcomes that get people back to life and back to work as soon as possible.

1) http://www.chqpr.org/readmissions.html – Center for Healthcare Quality & Payment Reform
2) http://www.modernhealthcare.com/article/20150803/NEWS/150809981 – Modern Healthcare (August 2015)
3) https://hbr.org/2015/09/what-has-the-biggest-impact-on-hospital-readmission-rates – Harvard Business Review (September 2015)
4) http://healthcarecomm.org/about-us/impact-of-communication-in-healthcare/ – Institute for Healthcare Communication
5) http://www.carechex.com/ScoringRatingMethods.aspx – Hospital Quality Scoring and Rating Methods, Comparion Carechex

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