Find health insurance plans and prices in states that use the state-based marketplace exchanges, instead of the federal healthcare.gov marketplace. Here are the links for 12 states and DC. The federal subsidies still apply to these state exchanges: CA, CO, CT, Washington DC, ID, MD, MA, MN, NV, NY, RI, VT and Washington state. The states will show Bronze, Silver, Gold and Platinum metal levels. Compare plans on monthly premium prices, deductibles, plan features and quality ratings. Open enrollment for everybody (except Medicare) between November 1 and December 15, 2019 for 2020. You may have to create an account before you can see the plan options. But each state will vary. If you lose coverage during the year, you may also qualify to enroll outside of the Nov.-Dec. open enrollment.
AARP provides links to each state to see the number of COVID-positive cases and deaths in nursing homes. Across the US, AARP estimates at least 43,000 nursing home deaths are due to COVID-19. In some states, a majority of coronavirus deaths are from nursing home residents and staff. Each state provides information – some more, some less – on the names and locations of nursing homes. In Illinois, for example, one can find the name and numbers of COVID-19 cases and deaths for every nursing home. In Minnesota, by contrast, only the names of facilities that have at least 10 coronavirus cases are released. The number of cases is not disclosed. AARP is pressing for more transparency. Easy to use website. Updated June 11, 2020.
Look up your nursing home to see how many confirmed COVID-19 cases and deaths occurred among residents as of July 12, 2020. CMS (Centers for Medicare & Medicaid Services) reports that more than 142,000 nursing home resident confirmed cases have occurred nursing homes. Many nursing homes also reported additional “suspected cases” (90,600). Some nursing homes may not have reported data yet. The nursing homes that did report also indicated almost 39,000 Covid deaths had occurred. The report is expected to be updated weekly. The Nursing Home Dataset is used best with the filter, using the name of the facility. You must click on Apply, in order for the filter to work. Not user-friendly. Considerable questions have been raised about the accuracy of the data, so consumers should be cautious.
Additionally, CMS has conducted special surveys on 14,687 nursing homes as of July 17 (over 90% of US nursing homes.) CMS released special targeted inspection reports on nursing homes whose surveys were completed by May 30). If available, they can be found on the Nursing Home Compare website. (On the main page, look under Spotlight). Inspection reports are available for nursing homes in the metro areas of Atlanta, Boston, Chicago, Dallas, Denver, Kansas City, New York, Philadelphia, San Francisco, and Seattle. Published by the federal government.
U.S. News 2020 list of best nursing homes use federal government CMS star ratings and quality measures from the CMS data in July 2019. Fewer than 3,000 nursing homes gained Top Performing status, out of more than 15,000. The top rated nursing homes selected by US News had to be high performing for either short-term rehab care, or long-term care, or both. Just 420 nursing homes qualified as top performing for both. There were 784 nursing homes that were categorized as Below Average for both short and long-term care. The methodology changed in 2019, and may not be compared to prior top nursing home lists. Also, consumers should check Nursing Home Compare ratings, which may show star ratings that are quite different than (possibly even opposite to) the US News ratings. Information on nursing homes from NursingHomeCompare published by US News Updated October 2019
Compare 2019 Vermont hospital outpatient diagnostic test prices for lab work, x-ray & imaging tests. Scroll to Pricing of Common Services at Community Hospitals, Pricing by Service Type. MRI charges averaged $1,942 [pelvis angiography] to $4,134 [MRI-brain, multiple sequences] with physician fee. CT scan of head, neck, face, chest, spine, pelvis, abdomen (overall CT average $1,358 to $4,120); digital screening mammograms average $548 with physician charge. Specific test prices for urinalysis, glucose, Metabolic Panel ($111 average), lipid panel ($97), PSA (average $131, range 61 to 267), CBC (range $59 to $72), strep test group A (range from $74 to $82), Pap test (average 122 to 129), pregnancy test (average $58), blood typing, OB ultrasound first trimester (average $903), x-rays, Cardiology EKG or echocardiogram, PT evaluation ($302 average, moderate complexity), colonoscopies ($3,660 without biopsy) and more. CPT codes listed. Some average prices in VT went down in 2019, which may support useful price comparisons among hospitals. Prices good through Sept. 2019. Tables 3B through 3O. Vermont probably has the best State site for hospital outpatient diagnostic test cost comparison. However, the coronavirus pandemic may have slowed updating the reports for 2020. No update as of August 5, 2020.
Vermont 2020 hospital ratings are called Act 53 report cards – legislation passed in 2003, requiring VT hospitals to publish annual community reports about hospital quality, safety, financial health, costs for services and more. This government site links the data, including outpatient prices. See if your VT hospital is average, above average, or below average. Health conditions include heart care, pneumonia, surgical infection prevention, central line associated bloodstream infections, c. diff. infections, hysterectomy infections, knee replacement and hip replacement infection rates, volume and death rates, readmissions, psychiatric hospital quality & more. This site permits access to Quality Ratings, Survival Rate information, links to patient satisfaction and current medical prices all on the same web page for easy access. Nurse staffing also available for 2020. Dates for other reports vary, usually up to 2018 or 2019 data. Information on prices for some procedures, and services such as physician office visits also available. Published at healthvermont.gov April-May 2020.
Compare Health Insurance plan ratings in Vermont, based on 2019 services. View number of denials, service problems, complaints and grievances on Blue Cross Blue Shield of VT (16.8% claims denial rate), MVP Health Plan (6.99% claims denial rate), and The Vermont Health Plan (33.5% denial rate). Each plan’s report is separate for the year. Act 152 Health Insurer Annual Reports for 2019 were filed with the Vermont Dept of Financial Regulation in May 2020.
Compare published prices for hospital Emergency Room visits, for all 14 hospitals in VT, according to level of severity and complexity. Statewide average ER price is $341 for Level 1 minor problem, before adding tests or procedures. Very few visits are this “simple”. Level 2 low severity ER visit average price is $501 before adding test costs. Level 3 moderate severity and complexity ER visit (the most common in the US) average price is $843 for hospital and physician charges, excluding tests and medications etc. Level 4 average price is $1292. Top base price for a Level 5 visit is $1830 per visit ($1275 hospital, $555 doctor fee). For consumer planning purposes, billing code Levels 3, 4 and 5 are most likely to occur. A recent study of Medicare patients found that the most common ER visit charge was for a Level 5 visit, right at the top of the complexity scale. Both facility and physician charges are shown – an amazing show of leadership in price transparency. Springfield Hospital’s Level 5 charge is $1215; the University of Vermont Medical Center’s Level 5 ER charge is just shy of $3000. Prices do NOT include lab tests, imaging tests or procedures during the ER visit. Prices are good from October 2018 to September 2019. Table 3D. No update as of Aug. 7, 2020.
How much does outpatient surgery cost in Vermont? To find 2018 prices (the most recent available), see Section called Pricing of Common Services at Community Hospitals. Table 2A lets you compare average gross charge (the closest you will get to average cost) for most common ambulatory surgery procedures at 14 general hospitals in VT. Prices for procedures such as cataract surgery (average $6,159), colonoscopy $3,999 average (range $1,628 [up 3%] at Northwestern Medical Center to $6,903 [up 53%] at Gifford Medical Center); upper GI endoscopy with biopsy ($3,519), knee cartilage surgery ($9,046 average, reduced 5%), arthrocentesis joint aspiration ($735), gall bladder removal (average $13,399, down 1%), breast biopsy (avg. $4,456), other biopsies; excision of skin lesion $2,461; ear tubes (average $3,756), tonsillectomy ($7,059, up 1.6%), bunion removal ($12,199 avg), hernia repair $12,960 (up 8%); circumcision cost $4,296, up 1.3%; fetal monitoring cost $799, up 1.9%; outpatient hysterectomy $22,969; peritoneal dialysis ($11,946, up 13%), and many more procedures. 12-month average charges ending Sept. 30, 2018, DO NOT include the surgeon or other physician fees. As with all of Vermont’s reports, the font size is about as small as you can get. Prices are about two years old; the 2020 Report Cards were published June 2020. Medical inflation has been about 6.4% over the past 2 years. Table 2B shows how many of those procedures the hospital did.
2020 Vermont Hospital Report Card shows average inpatient prices (gross charges) for each VT hospital’s most frequent inpatient admissions. Sample average prices include newborn delivery (normal newborn $3,323; newborn with medical problems = $4966, but close to $18,000 if the baby had major problems), cesarean section ($17,000 to $21,000), average cost for vaginal delivery $9,811 without complications; pneumonia; total hip or knee replacement (average $40,000), depression (average $15,000), psychoses such as schizophrenia (average $38,000), COPD & emphysema, heart failure, chest pain, rehabilitation, heart rhythm problems, back problems, Spinal fusion about $67,000; kidney or urinary tract infection, and other hospital stays. Compare costs on nearly 60 different types of cases, listed by MS-DRG. Table 1A, 2017-2018 average charges were published June 2020. Price hikes for 2020 are likely.
Which hospitals have the largest inpatient market share (counts) in Vermont for each major service line? The State of Vermont (Act 53 Hospital report cards) list volume of inpatient hospital admissions for each VT hospital, along with the statewide average price (charge) for the top 20 types of admission (by MS-DRG). See Table 1B – Counts. 2020 report cards show counts to calculate market share for year ending Sept. 30, 2018. Updated June 2020.
Physician license lookup is provided by the Vermont Board of Medical Practice. Covers MDs only. Osteopathic doctors must be verified at the state Office of Professional Regulation (see next listing). Extensive physician profiles including years in practice, malpractice items, education, training and board certification, and past hospital appointments in other states. Doctor license lookup is easy to use at the VT Department of Health website.
Lookup license information on osteopathic physicians and other professionals through the Vermont Office of Professional Regulation. In addition to osteopathic doctors, consumers can find license information on chiropractors, nurses, nursing home administrators, psychologists, pharmacists, social workers and more. This site is through the Vermont Secretary of State. Select Osteopath to search by doctor’s (DO) name.
Find out how many outpatient surgeries (selected types) are done at each Vermont hospital, and the average price statewide (average gross charge) for period of Oct 2016 to Sept. 2017. Prices do not include physician charges. Volumes include cataract surgery, endoscopy, cholecystectomy (gall bladder surgery), colonoscopy, ear tubes (myringotomy), tonsillectomy, bunionectomy, circumcision, breast biopsy, outpatient cardiac catheterization, hernia repair and more. Part of the State Act 53 Hospital Community Report series, Table 2B published May 2019
Detailed Vermont hospital financial comparisons showing 2018 and 2019 actual results, plus 2020 budget. In addition to typical financial statement items (revenue, expense, profit, assets, liabilities), staffing information, capital expenditures planned through 2023, inpatient volume, average length of stay, detailed financial ratios and other operating statistics. See Tables 4 to 14. Updated April 2020. Provided by the state of VT Green Mountain Care Board.
Pharmacy prices used to be listed for about 90 prescription drugs at a Vermont government site (Office of Attorney General of VT). Consumers could compare medication drug prices. Launched in 2007, unfortunately, some time after 2010 the Drug Price Finder service was discontinued. Formerly at atg.state.vt.us
Compare what hospitals in Vermont are charging for physician office visits in 2018-2019. For example, code 99213 averages $155 for the physician. Since hospitals may charge an additional fee, the total charge in the state is about $208 per visit. Fees ranged from $98 at Northeastern VT Regional Hospital to $662 at North Country) for an established patient code 99213. Code 99214 average price is $262. New patient prices also shown. If non-hospital medical groups exist in VT, their fees are not shown. Provided by state of Vermont; prices good thru September 2019
County Health Rankings 2020 for all states, lets consumers compare your county’s health status to the rest of your state. It provides the latest results for smoking, obesity, alcohol use, flu vaccination rates, preventable hospital stays; primary care, dentist and mental health provider rates, percent uninsured (as of 2017), alcohol impaired driving deaths, severe housing problems, social associations, and much more. Very interesting information on health behaviors and health outcomes. Robert Wood Johnson Foundation and Univ. of WI Population Health Institute
Annual United States Chartbook on Health is a report on trends in health statistics. Publication: Health, United States, 2018 edition, by the National Center for Health Statistics (NCHS). Chartbook contains text and figures showing long term trends in the health and healthcare of Americans; most data to 2017; 47 trend tables; 20 figures with charts. Published by CDC 2019
Kaiser State Health Facts provides individual state profiles and for the US as a whole on a variety of healthcare subjects. Compare states on health status, health insurance coverage, costs, minority health, and more. Covid-19 cases, deaths and testing have been added to the Health Status category in 2020. In the Demographics and the Economy category, find information on population, poverty, income, employment, state budgets, taxes, voting and voter registration. From the highly respected and trusted Kaiser Family Foundation; Dates vary from 2015 to 2020
All states are ranked by The Commonwealth Fund in this State Scorecard on Health System Performance – Aiming Higher. Interactive database to see just your state. Better yet, check out who is at the top of the list: Hawaii, Massachusetts, Minnesota, Washington, Connecticut, Vermont, Rhode Island, Iowa, Colorado and New Hampshire. Data periods vary; most are current to 2017; 47 measures; published June 2019
State Snapshots show strengths, weaknesses and opportunities for improvement in health and healthcare, based on data from the National Healthcare Quality Report (NHQR). How does your state rate? Updated annually by the Agency for Healthcare Research and Quality, although dates are not clear unless you drill down to the specific measure
The nonprofit Accreditation Association for Ambulatory Health Care (AAAHC) currently accredits over 6100 organizations in a wide variety of ambulatory health care settings, including ambulatory and office based outpatient surgery centers, community health centers, endoscopy centers, lithotripsy centers, some managed health plans, medical group practices, retail clinics, urgent care centers, specialty services, and workplace clinics. (See also Joint Commission site for hospital-owned ambulatory surgery center accreditation.)
List of Accredited Chest Pain Centers – some with PCI (percutaneous cardiac intervention). Must meet emergency department requirements and standards for timely diagnosis and treatment. List is interactive by state or type of accreditation, including atrial fibrillation (A Fib) and cardiac cath; heart failure, heartCARE center and more. Shows location of each hospital. Provided by the nonprofit American College of Cardiology (ACC)
The Joint Commission (formerly JCAHO – Joint Commission on Accreditation of Healthcare Organizations) accredits hospitals and other healthcare organizations. Quality Check provides accreditation and comparison information for hospitals, behavioral health care, home health/hospice, laboratories, some nursing homes (called nursing care centers) & assisted living centers, and other health care services. A few actual scores for acute care hospitals and behavioral health (mental health) programs may be available for 2018. For nursing homes, consumers are advised also to check state inspection reports . We recently discovered a 1-star Florida nursing home (the lowest possible rating in the state) had been accredited by the Joint Commission. Consumers are always advised to check multiple sources and ratings when researching quality of care. Conflicts in scores may suggest quality is not consistent.
The Acupuncture Referral Service helps consumers find an acupuncturist. List of people who are licensed to do acupuncture, by state and country – note, many people are listed twice. Besides the US and Puerto Rico, professionals in Canada, Australia, UK (England, United Kingdom), India, and other countries in Europe, Asia and the Middle East are included in the directory. Interesting observation: no acupuncturists in China are listed
Find an affordable clinic for primary care, mental health or a dentist. List from HRSA, shows federally funded community health centers that provide primary medical care, pregnancy care, physician office visits, immunizations, dental care, mental health and other services, regardless of ability to pay. Search by state, county or zip code. Every state appears to have special clinics for those without insurance. Federally qualified health centers (FQHCs) have sliding fee scales for people up to 200% of poverty level. Perhaps one of the best healthcare programs in the United States, and not that many people know about it.
The ALS Association is a non-profit dedicated to amyotrophic lateral sclerosis (“Lou Gehrig’s disease”). They select, certify and support regional ALS centers and clinics they recognize as the best in the field; and which have neurological diagnostics and imaging, and available certain on-site licensed and certified ancillary services
American Medical Association (AMA) Doctor Finder site provides information on members of the AMA first, but also lists information on non-member physicians. Site reports over 814,000 physicians listed, and if they are members of the AMA, shows a detailed profile with board certification as well as training. Click on non-members to see full list. May show whether physician is Board-certified or not.
Find average charge for about 80 outpatient ambulatory surgery procedures done in hospitals in 2007 (excluding surgeon’s or other physician fees.) Consumers will need to adjust the 2007 prices to estimate 2020 costs; add at least 46% for a rough estimate. Overall average was $6,100, compared to nearly $40,000 for inpatient surgery. In today’s 2020 medical dollars, that would be about $9,000 vs. $58,000. Average colonoscopy & biopsy price in 2007 was $2,369; upper GI endoscopy $3,131; cataract & lens was $4,870; tonsillectomy $5,286; knee cartilage $7,357; hernia repair $8,187; outpatient gallbladder removal (cholecystectomy) $10,838; breast biopsy $3,863; lumpectomy $7,458; ear tube surgery (myringotomy) $3,547; D&C $6,366; arthroscopy $8,970; incontinence procedures $9,929; varicose veins $8459; bunionectomy $7699; wrist fracture $7,807; $4,770 for circumcision. AHRQ Statistical Brief #86 published February 2010 unfortunately still has not been updated. No longer Editor’s Pick
HealthGrades list of America’s Best Hospitals shows their choice for the top 50 hospitals and 100 best and top 250 hospitals in the US, based on clinical quality for Medicare patients over 3 years ending 2018. List shows which hospitals have held clinical excellence for 6 or 7 years (top 1%), and those for 5 consecutive years (top 2%). The 250 best hospitals (top 5%) were formerly known as receiving the Distinguished Hospital Award for Clinical Excellence. HealthGrades examined complication rates or survival rates for 32 diagnoses (such as heart failure, COPD, pneumonia, stroke, diabetes, pancreatitis, sepsis) or surgical procedures (such as hip or knee replacement, gall bladder removal, back surgery, bowel obstruction, prostatectomy, angioplasty, valve surgery, and heart bypass). Hospitals are listed by state; 40 states had hospitals that ranked in the top 5%. Published Feb. 2020
Find out what your doctor’s specialty is by checking his/her certification at the American Board of Medical Specialties (ABMS). ABMS is a highly-regarded, not-for-profit organization comprising 24 medical specialty boards, that oversees physician certification in the US. See whether your doctor is board-certified in his/her specialty (such as Internal Medicine, Pediatrics, Family Medicine, OB/GYN, Surgery, Orthopedics, Emergency Medicine, Radiology, etc.) and in his/her subspecialty (such as Cardiovascular Disease, Geriatric Medicine, Oncology, Endocrinology, Neonatal Medicine, Pulmonary Disease, etc.) Click on Is Your Doctor Board Certified on the certificationmatters.org page (sponsored by abms.org). Registration (free) is no longer required, but well worth it if required in the future. We encourage visitors to use the site.
Use the American Dental Association (ADA) Directory to find a dentist near you. This database helps you find a dentist who belongs to the American Dental Association. Brief listing shows name, practice specialty, location and contact information. Some listings show where the doctor received dental education, and which insurances are accepted.
The American Hospital Directory at ahd.com shows average charge and average cost for many hospital outpatient services. Charges and average costs for the 20 outpatient Ambulatory Payment Classifications (APCs) that made up the highest Medicare outpatient payment to each hospital. Critical access hospitals are excluded. List varies by hospital. Top 20 procedures may include volume (number of claims) and cost for colonoscopy, laparoscopy, CT, MRI, clinic and emergency (ED or ER) visits, x-ray tests, upper GI, lower GI endoscopy, arthroscopy, cataract with lens, angiography, echocardiography, hernia repair, infusion therapy, nerve injection, observation services, outpatient cardiac catheterization, ultrasound. Scroll to bottom of the hospital page to find Outpatient Utilization Statistics. Some rural critical access hospitals may not show any outpatient test and visit prices. Also shown: inpatient market share by local zip code; net income. Link is to the Free Hospital Information
What are the average costs for assisted living, home health, and nursing home care in 2019? According to Genworth, the typical cost for home health aide in a licensed agency was $23 per hour nationwide (median). A homemaker cost was just slightly lower. A private one bedroom Assisted Living facility cost more than $48,000 per year ($4,051 per month), though it was $135,450 per year in Washington, DC. The Semi-private nursing home median room rate in the US was $247 per day (more than $90,000 for a full year); $280 per day for a private room. Rates vary greatly across the states. In Alaska, the median price for a private room in a nursing home was a whopping $994 daily rate. Almost half (22) of the states and DC have an annual cost for a semi-private nursing home room at over $100,000 per year. All states listed; adult day care and homemaker rates also shown. Survey by Genworth Financial (CareScout) in May and June 2019; published October 2019
Find the average health insurance cost in each state, for 2018. The Kaiser Family Foundation (KFF) shows average Single and Family health insurance premiums for US (employer coverage, $6,715 single, $19,565 family) using MEPS data for 2018. Family rates were lowest in North Dakota ($1 7,337); highest in New Jersey ($22,294). Tennessee had the lowest Single premium rates ($5,971), followed by Arkansas. Alaska had the highest average single premium at $8,432. Single deductible averaged $1,846. Hawaii had the lowest single person deductibles in 2018, averaging $1,308, jumping $443 over the prior year’s average deductible. Washington DC also had an average $1,308 deductible. Average deductible for a single plan topped $2,400 in Maine. On average, employers paid 79% of the single premium, and paid 72% of the family premium. Employees paid the difference: 21% of single premium cost and 28% of the family monthly premium. See specifics in each state. MEPS is the Medical Expenditure Panel Survey. Updated 2020.
The 2018 average health insurance premiums and amount of employee contribution for single, single-plus-one, and family coverage by selected cities and metropolitan regions, or remainder of state shown in this MEPS table of costs for private-sector businesses. Average single premiums in many parts of the country continue to exceed $7,000 or even $8,000 (Alaska and the Tampa, St. Petersburg, Clearwater Florida metro area). Lowest single rate $5,519 was in Memphis, TN. Average employee-plus-one premiums were over $11,000 across the US; exceptions were Las Vegas area and Memphis, where premiums for employee-plus-one cost $10,900. Alaska’s employee-plus-one rate topped $16,000 in Anchorage. Family premiums were best in Des Moines, Iowa at $16,257 and Albuquerque New Mexico ($16,788); but topped $23,000 in the New York metro area and parts of New Jersey. Average Single contribution was under $2000 across the US, except in the parts of Massachusetts outside of the Boston-Cambridge metro area. Coverage levels and plan design will vary. Data from MEPS, the Medical Expenditure Panel Survey, Insurance Component.
The Behavioral Health Facility Locator helps consumers find a treatment clinic or facility for mental health, alcohol, drug, and substance abuse treatment center “near me”. Search up to a 200-mile radius or more, including crossing state lines. The Detailed search allows specifying outpatient, inpatient, residential treatment, or a mix of mental health and substance abuse services, and permits a full national search. Site by the federal Substance Abuse & Mental Health Services Administration (SAMHSA).
Look up hospital ratings for cardiac surgery in your state, through the Society of Thoracic Surgeons (STS). Many hospitals voluntarily report their results, which are posted here for adult coronary artery bypass graft (CABG), valve replacement, congenital heart surgery and lobectomy for lung cancer. Most results cover the time period through June 2018. Most hospitals get two stars for “as expected” performance. Outstanding hospitals get 3 stars; under-performing hospitals get 1 star. Search by state or name of hospital to find the best. Excellent website. The Society of Thoracic Surgeons is a not-for-profit organization representing more than 7,600 surgeons and others dedicated to ensuring the best possible outcomes for surgeries of the heart, lungs, esophagus, and other surgical chest procedures.
The Blue Cross and Blue Shield companies have designated national Blue Distinction Centers meeting their standards and selection criteria for bariatric weight loss surgery, cardiac (heart) care, fertility care, organ transplants (e.g. adult and pediatric bone marrow/stem cell, heart, lung, liver, pancreas (adult only) transplants, total knee and hip replacement, cancer care, maternity care, spine surgery, cellular immunotherapy, and gene therapy for ocular disorders. Quality criteria can be found from the home page. Substance Use Treatment and Recovery distinction to launch Jan. 1, 2020. In addition to Blue Distinction Centers, the Blue Distinction+ (Plus) designates high quality centers that also consider cost of care. (No further information is available on prices.) Interactive database; updated 2019
CareChex by Quantros lists the 2020 top hospital in each state for Medical Excellence. No methodology is shown at the website. (Some of your questions may be answered by a chatbox person.) 2020 awards are based on data from CMS (from Oct. 2015 to Sept. 2018; HCAHPS patient satisfaction scores may or may not be included in the scoring). In addition, five health system were selected for excellence. Winners were announced Oct. 31, 2019. CareChex is a division of Quantros, a for-profit software solutions company. The company appears to be a competitor to HealthGrades or Watson Health (Truven).
Find certified mammography facilities near you. Searchable list of nearly 9,000 mammography facilities by zip code or state that are certified by the Food and Drug Administration (FDA) or Certifying State as meeting baseline Mammography Quality Standards for equipment, personnel and practices. Use the complete state list (sort by city) if you want a mammogram in another zip code – or you will likely miss some nearby facilities. As of October 1, 2019, 96% of facilities had been inspected, and 84% had no violations, according to the MQSA Scorecard Statistics. About 40 million mammograms are done annually.
CMS lists nursing homes in any state and District of Columbia that have a history of serious quality problems. These Special Focus Facilities (SFF) have been officially entered into the federal government’s SFF program to monitor care. Homes on the list may have a history of “yo-yo” compliance, with a good survey followed by substandard quality on the next, thus unable to sustain good care. Some nursing homes are listed as Showing Improvement or having graduated out of the program. In addition, last year, CMS added hundreds of nursing homes (7 pages) that are candidates for the SFF program, based on quality issues over the prior 3 years. Up to 30 nursing homes per state are on the Special Focus Facility Candidate list. Updated July 29, 2020.
American College of Surgeons offers the Commission on Cancer – Find Cancer Centers or Surgeons – Search by zip code (or city and state) and up to a 100 mile driving distance. Facilities are accredited by the Commission on Cancer (CoC) of the American College of Surgeons. Accreditation of a cancer center is based on ability to comply with established CoC standards
Find and compare performance levels of nearly 1400 federally qualified community health centers (FQHCs) in each state. Ratings on clinical measures include diabetes, hypertension, prenatal care, low birth weight, asthma, childhood immunizations, depression screening, weight management, dental sealants, cervical cancer screening and more. See Clinical Data section for three-year trends. Altogether, the health centers have about 12,000 different sites across the US. They receive federal money to lower the price to low income patients. They are locally owned and managed. Services include primary medical care, dentist services, and mental health care. Excellent program if your community is lucky enough to have a community health center. UDS data from 2018
WhyNotTheBest.org is a helpful website to compare hospitals and check ratings, although the number of measures is few. Allows comparisons within a state, up to 70 hospitals at a time. Currently using 2017-2018 data for most measures. Some measure are older. Emergency room care, blood clots, infections, influenza vaccination, patient satisfaction, survival rates (mortality for heart care, pneumonia, COPD and stroke), readmissions, old charges from 2011 and more. Must SCROLL in the measures selected box, to find all the other kinds of reports and measures that don’t readily appear. Trends are shown for many hospitals, and you might be able to find Top Performers in the country at this website. Operated by IPRO
Northwestern Mutual surveyed assisted living facilities, home health agencies and Medicare-certified nursing homes in all states and DC in 2015. Average rate for assisted living was $4383 per month ($52,591 per year). Average daily rate for nursing home private room was $273 per day; home health aides averaged $26 per hour, but ranged from $18 per hour to $43/hr. depending on city
The Dartmouth Atlas of Health Care highlights the wide variations in how health care is delivered across the United States. The project is run by Center for the Evaluative Clinical Sciences at Dartmouth Medical School. Online tool provides comparisons by geographic region (state, HSAs-Hospital Service Areas, or HRR-Hospital Referral Region) for Medicare healthcare use (data through 2015). While the tool is relatively easy to use, the conceptual understanding of the reports requires technical sophistication. In 2020, the number of COVID-19 cases in the past 14 days is shown for each region. A timelapse map of the growth in COVID cases in the US, total cases and deaths are also shown by region.
Compare services and ratings on kidney dialysis facilities in any state or US territory, by Medicare.gov. Quality measures show relative survival among facilities and quality of care provided to Medicare patients at hospital-sponsored centers, nonprofit and for-profit dialysis centers. Patient satisfaction results also shown for each dialysis center. Time periods covered, are generally 2017 to 2018. Resources on kidney failure and end stage renal disease (ESRD) also linked
The Directories website at MedlinePlus may be the only directory mega-list you will ever need. Directory links for doctors, dentists, hospitals, chiropractors, psychologists, hospice programs, and more. Extensive list of directories, although some sites only list those who are members of their association, and do not list others who may be licensed in that field. Specialized directories (e.g. Find an Eye MD, Directory of Asthma Camps, Sleep Centers, or Alzheimer’s Disease Research Centers) can also be located here. Five pages of listings
Directory of hospitals in America is alphabetical; or search state-by-state. Comprehensive hospital index of over 6000 hospitals prepared jointly by the American Hospital Association and US News & World Report. Search by location. Descriptive information, and links to hospitals’ websites. Includes Guam, Puerto Rico. Well-maintained site
Patients may review and rate anyone called Doctor (such as chiropractors and dentists) in the US and selected countries at this site: RateMDs.com. As of October 2019, few physicians had more than 30 patient ratings. Most physicians only have one patient rating. Doctors are rated on their staff, their punctuality, helpfulness and knowledge. Unable to sort list by rankings or number of ratings. Consumers may add a comment. Be VERY CAUTIOUS in using these ratings as the results may NOT be valid.
Estimates of the number and percent uninsured under age 65, by state and county for 2018, provided by the U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE) released April 2020. Once you’ve located your counties of interest, click on it to see the actual numbers and recent trends. The first year that subsidized insurance was available on the health insurance exchange was 2014. Uninsured rates in the US declined steadily from 2013 when the uninsured rate was 16.8% through 2016 when it reached a low of 10.0%. Since 2016, the percent uninsured has crept up slightly to 10.4% in 2018. Compare your county’s rate to your state and the US.
Find Fertility Clinic Success rates in ART clinics (Assisted Reproductive Technology) in the US and Puerto Rico. This 585-page report is by the CDC in conjunction with Reproductive Medicine societies. Shows success rates by age of woman, and both fresh and frozen embryo transfers (nondonor and donor eggs). One-page summaries for each of 448 fertility clinics reporting 2017 data. Approximately 1.7% of all infants born in the United States every year are conceived using ART. Nationally, for women under age 35, 48.5% of transfers using their own eggs resulted in live births. Success rates declined with age of woman. Success rates for ART transfers using frozen embryos from a donor resulted in live births 46.5% of the time (women of all ages combined). In evaluating fertility clinics, consumers can see how large or small the reproductive program is in any state. Published Oct. 2019.
Find a doctor at Physician Compare, a Federal government website at medicare.gov. Site lists many physicians by city and specialty, including podiatry. Not too much information, usually less than you get at a state’s licensing site. Maybe in the future it will contain useful quality comparisons. In addition, not all licensed physicians are included. Some nurse anesthetists, psychologists, social workers, therapists, nurse practitioners, physician assistants & audiologists may be included in the hospital profile under Affiliated Clinicians.
Use the online directory to find a board-certified plastic surgeon for your plastic surgery such as breast augmentation or breast reduction, eyelid surgery, facelift, botox or hyaluronic acid injection, laser hair removal, liposuction, nonsurgical fat reduction, nose surgery (rhinoplasty) or tummy tuck. Web site by The Aesthetic Society, also known as the American Society for Aesthetic Plastic Surgery (ASAPS).
Find an Aging Life Care Professional, formerly called geriatric care manager. The Aging Life Care Association (ALCA) was formerly the National Association of Professional Geriatric Care Managers, Inc. This national directory is easy to use. Credentials of members listed will vary widely. The credentials of the Advanced Professionals may be the most useful. Not all areas of the US are covered.
Find a cancer specialist (oncologist) through the American Society of Clinical Oncology (cancer.net) ASCO website. Use the interactive database to help you find a board-certified physician with specialties in the specific type of cancer expertise you’re interested in, or types of oncology, tumors, etc.
Find an orthopedic surgeon anywhere in the US. Easy-to-use and informative site, by the American Academy of Orthopaedic Surgeons (AAOS).
Health insurance exchange website helps small businesses and individuals know what health insurance options are available to them. Search by zip code. Can compare 3 companies or plans at once; approximate monthly premiums are shown. No recommendations or rankings. These are private plans that are OUTSIDE of the health insurance exchange marketplace, and do not qualify for advance premium tax credit. This list may help you get an idea of prices before talking with an insurance agent. From HHS at US government
Find individual health insurance plan options and prices at healthcare.gov. This is the ONLY health insurance site to use if you want (and qualify for) the federal subsidies for affordable health insurance AND your state participates in the federal marketplace exchange. Compare plans on monthly premium prices, deductibles, plan features and star quality ratings. The federal marketplace exchange shows Bronze, Silver, Gold and Platinum metal levels. It first opened for 2014. People who don’t get subsidies can also choose a plan and enroll at healthcare.gov. Open enrollment for everybody (except Medicare) between November 1 and December 15, 2019 for 2020. Select Preview Now if you just want to scan the plans before you create an account. At minimum, enter your age, or you may get false prices. If you lose coverage during the year, you may also qualify to enroll outside of the Nov.-Dec. open enrollment. Links are provided to your state marketplace if your state has its own health insurance website. Editor’s Pick.
Health insurance cost comparisons for Federal government employees. Compare the benefits, member satisfaction, and employee costs for all plans at once. Consumers can also select 3 health insurance plans at one time to see out of network benefits. Web site for Federal Employees Health Benefits (FEHB) Program is from US Office of Personnel Management (OPM). Enrollee premium, deductible, copays and maximum out of pocket costs are shown. Search by zip code; choose local plans and/or national plans. Convenient and current for 2020. Helpful to federal employees and others. The amount that taxpayers and government institutions pay toward the total health care premiums is no longer readily available.
Check GuideStar.org to find executive compensation and other Form 990 information on nonprofit organizations. Free registration is required to access the basic database, but it is worth your time. GuideStar.org is a go-to source. Most tax-exempt nonprofits file a Form 990 with the IRS, which shows important financial information and executive compensation (or portion of executive comp) received from that organization. GuideStar reports having over 26 million annual searches conducted on 2.7 million nonprofits listed on GuideStar.
Compare hospitals on patient satisfaction scores updated in 2019. Use the Find and Compare hospitals tab to view patient satisfaction HCAHPS survey ratings and opinions by hospital inpatients across the US. Side by side comparisons for 3 hospitals at a time, 2018 data. Find out how many patients would recommend their hospital, and the percent who give their hospital a 9 or 10 score. Voluntary hospital participation. Federal government oversees the HCAHPS survey process (H-Caps) – Hospital Consumer Assessment of Healthcare Providers and Systems
Healthcare.gov reports the rate requests and final (now posted) rate increase or decrease for Jan. 1, 2020, by name of health insurance plan for individual policies or small group health plans on – and off- the health insurance exchange. Search by state, and look for increases effective Jan. 1, 2020. Updated for 2020
HealthInsight provides national rankings for all home health agencies in the US. Overall composite home health ratings of quality and patient satisfaction are based on both quality and patient satisfaction. The rankings create a summary of 8 (minimum) to 16 measures of quality of care in 2017. The satisfaction summary is from the 25-question HHCAHPS survey, grouped into 5 measures of patient satisfaction in 2017-2018. Health Insight, composed of locally governed organizations in four western states, used the national CMS measures and data to develop a composite ranking. Easier to use than the federal CMS website, but less detail. Interactive tool allows very fast search by state. You must know the name of the agency, since you cannot search by zip code.
Check HealthInsight (Comagine Health) to find national rankings for hospitals in all states. The overall hospital rankings are based on a summary of patient experience (satisfaction), hospital infections, mortality (for heart attack, heart failure and pneumonia) and readmissions. Health Insight, a project of Oregon, Utah, New Mexico and Nevada, developed a helpful composite ranking for nearly every hospital in the nation, using national CMS measures and satisfaction ratings from inpatients. Performance on preventing infections contributes 45% to the hospital’s national ranking. Patient experience results contribute 35% to the score. Mortality and readmissions each contribute 10% to the rankings. Results shown by state. Easier to use than the federal HospitalCompare website, but less detail. Dates are from admissions primarily in 2018, pulled from CMS hospitalcompare in November 2019.
Find national rankings for nursing homes (all states) by HealthInsight. Overall composite nursing home quality ratings based on a summary of 15 quality measures on over 15,000 nursing homes in 2019. Health Insight, developed by Utah, Nevada, and New Mexico, used the national CMS measures and data to develop a composite ranking. Easier to use than the federal CMS website, but less detail. Must know the name of the facility. The database is not searchable by city. Updated July 2020.
Home Health Compare is a free search tool from Medicare that gives detailed information about Medicare-certified home health agencies. Search by county or zip code and see performance scores related to home care services. Find the graphs to compare agencies on measures related to managing daily activities, pain, teaching patients or their caregivers, getting readmitted to the hospital and more. Five star rating system and actual scores. Patient satisfaction ratings included, with a national average of 78% who would recommend their agency. Report card shows 2017 or 2018 data.
Find a hospice or palliative care provider at this site by NHPCO. The National Hospice and Palliative Care Organization (NHPCO) is the largest nonprofit membership organization representing hospice and palliative care programs and professionals in the US. Their searchable database helps consumers find a member hospice, palliative care program or bereavement service.
Compare up to 3 hospices at a time at Hospice Compare by Medicare.gov. Site currently reports performance on 7 quality measures related to patient preferences and quality of care in managing pain and treating symptoms, 2018 data. Family satisfaction is also reported, including family training and communication, emotional support, pain management, overall rating of the hospice and willingness to recommend the hospice (national average is 84% would recommend). Site was new in August, 2017, and is updated quarterly by CMS. Search by zip code, state or city. All hospice agencies report, or face financial penalties. Published by the federal government. Excellent website.
Find Hospital Clinic and Office Visit charges (average price) for 2017, and the payments that Medicare made. Find average charges for about 13,000 different codes (depending whether office or hospital facility-based). National average prices are in the Procedure Summary file. Extremely difficult to use, even if somewhat familiar with using Excel files. File uses HCPCS codes. The most common codes were office visits 99213 (average charge about $134) and 99214 (average charge about $201). Medicare allowed about $71 for code 99213 and about $105 for 99214. Lab tests, x-ray, emergency department visits are in the file. Physician charges may be available in the Provider Summary Table. Calendar year 2017 data from CMS updated 2019.
Find 30-day death rates for cardiac hospitalizations: heart failure, heart attack and CABG patients. Hospital Compare, the federal government site from CMS, shows whether hospitals meet expected 30-day survival rates for heart attack and heart failure Medicare cases. National death rates were 12.9% for heart attack, 11.5% for heart failure and 3.1% for CABG (heart bypass) surgery patients. Nationally, these rates improved over the prior 3-year period. Compare hospitals in your area. The number of hospitals that were significantly worse than the national value were 11 for heart attack, 146 for heart failure and 19 for CABG. Results updated 2019, 2015-2018 data
Find 30-death rates for hospital pneumonia patients at Hospital Compare. Federal government site from CMS shows whether hospitals met expected 30-day survival rates for Medicare pneumonia patients. The national Risk-Adjusted death rates (mortality rates) were 15.6% for pneumonia. Of US hospitals measured and reported, vast majority were statistically no different than national average; 270 hospitals had worse survival rates; 264 had better survival rates. Find pneumonia mortality ratings under Complications and Deaths measures. Results use 2015-2018 data, updated 2019
Find 30-day death rates for patients with stroke, at Hospital Compare. Select the Complications and Deaths tab after you’ve selected your hospitals. Federal government site from CMS shows whether hospitals met expected 30-day survival rates for Medicare stroke patients. The national Risk-Adjusted death rates (mortality rates) were 13.8% for stroke, an improvement over last year’s report. Of US hospitals measured and reported, vast majority were statistically no different than national average; 76 hospitals had worse survival rates; 46 had better survival. Results use 2015-2018 data, updated 2019
Visit Hospital Compare to find hospital star ratings and complications for hospitals in all states. Federal government (at medicare.gov) gives 1 to 5 stars and compares hospital ratings for heart attack (AMI), heart failure, pneumonia, COPD, stroke, hip & knee, preventing infections and surgical complications, timeliness of Emergency (ER) dept., use of medical imaging. Most data are from 2018-2019; some ratings are older. Includes death rate comparisons from heart failure, heart attack, pneumonia, COPD, stroke, CABG; and return to hospital (readmission) rates. Click on Timely & Effective Care, or Complications. Shows patient satisfaction HCAHPS ratings (patient experience opinions) from 2018-2019. Some info on colonoscopies and cataracts. Editor’s Pick because the government standardized broad ratings for all hospitals, and most ratings are based on more than just Medicare patients. However, it is still complicated. Small volume hospitals will not show data for some measures. Be sure to click on Show Graphs or View More Details. Today’s stars may reflect older data than shown at the website. Read the fine print. Updated 2020.
Find 30-day death rates for COPD patients at Hospital Compare. Select the Complications tab after you’ve chosen the hospitals you want to compare. Federal government site from CMS shows whether hospitals met expected 30-day survival rates for Medicare COPD patients. The national Risk-Adjusted death rate (mortality rate) was 8.5% for COPD. Of US hospitals measured and reported, the vast majority were statistically no different than national average; 72 hospitals had worse survival rates; 58 had better than average. Ratings results use 2015-2018 data. Updated annually and each July
Find hospital rates of scheduling early C-Sections, from Leapfrog. Compare hospitals on Early Elective Delivery and other Maternity measures. Goal was to reduce rates of scheduling C-Sections before the recommended 39 weeks, without a medically-indicated reason. The best hospitals have a 0.0% rate. Medical experts recommend that babies need at least 39 completed weeks to develop fully, which includes having a fully developed brain and other organs. Unfortunately, many hospitals do not report. See Maternity results on the 2019 hospital survey by the Leapfrog Group
Hospital Ratings (5-star, 3-star, 1-star) for over 30 diseases & inpatient procedures: Stroke, back surgery, COPD, diabetes, gall bladder surgery, bowel obstruction, GI Bleed, hip fracture repair, hip replacement, total knee replacement, prostate removal, TURP, hysterectomy (listed under gynecologic surgeries), respiratory failure, pneumonia, cardiac bypass, heart attack, heart failure, angioplasty, defibrillator, pacemaker, valve surgery, sepsis, pancreatitis, pulmonary embolism, abdominal aneurysm, stomach surgery, peripheral vascular bypass & more. Probably Medicare-only data for most conditions, although some states provide maternity, appendectomy, and bariatric surgery (gastric bypass) data. More extensive list than the federal government’s site. Publicly-traded company. Most data in 2019 ratings are from Medicare patients, from 2015 to 2017. Patient satisfaction ratings (2017 data) are featured by HealthGrades. One hospital at time, unfortunately. No longer Editor’s Pick, since HealthGrades removed the 3-year patient volume, and actual mortality or complication rates compared to predicted. Mostly, the site shows which ratings awards were given to the hospital by HealthGrades – a fee likely was required for publicizing the award.
MEPS data reports average health insurance premium cost of $6,715 per year (about $560 per month) from 2018 for a single person’s policy. Costs are for employee enrollees. Only three states managed to come in, just barely, under $6,000 for a year for one person: TN, AR and MS. Employee contributions were the lowest in Hawaii at about $63 per month, and in Washington state, at about $80 per month. Employer contributions picked up the rest of the cost. Employees paid on average $159 per month in Massachusetts, the highest contribution. Average single employee contribution in US was about $119 per mo. ($1,427 per year) or 21% of the total premium; employers paid 79% of single coverage premiums on average. Compare how much a month health insurance costs in each state. Benefit coverage varies by state and policy. Kaiser Family Foundation (KFF) prepared the tables using MEPS data (Medical Expenditure Panel Study).
J.D. Power and Associates selected Kaiser Foundation Health Plan as its top Medicare Advantage plan for 2019, the only plan to get a 5-star rating. Highmark came in second with 4 stars; Humana also rated 4 stars overall. Other Advantage plans compared (in order of preference) were Aetna, Centene, Anthem, UnitedHealthcare, and Cigna HealthSpring. Two stars went to WellCare, BlueCross BlueShield of Michigan and Blue Cross Blue Shield of MN. Commercial plan ratings are listed by state, for selected states only. Ratings factors were Overall member satisfaction (consumer opinions), Billing and payment, Communication, Costs, Coverage and benefits, Provider choice and Customer service.
Kaiser State Health Facts shows total uninsured and race/ethnicity minority comparisons for health insurance coverage and uninsured. Shows 2018 data, the fifth year of coverage through the Health Exchanges. Highest overall uninsured rates were in TX (20%); Florida and Oklahoma and Georgia tied for second worst at 16% uninsured; Mississippi followed with 15% uninsured. American Indian/Alaska Native uninsured was 22%; Hispanic uninsured was 19%; black uninsured was 11%, compared to 10% for US overall. This represented no improvement over 2017. White uninsured was 8%; Asian uninsured remained at 7%.
The Leapfrog Group, an employer-based coalition, asks hospitals to voluntarily report how closely they follow recommended quality and safety practices. CLICK on the blue [i] to the right of each green bar chart to find out if your hospital meets survival expectations and/or volume standards of 50 very-low birth weight babies for High-Risk Delivery-Neonatal ICU patients per year. Other volume standards are also set for pancreatic resections and other cancer surgery. Info on infection rates and early elective cesarean deliveries are reported. Many, but unfortunately not all hospitals participate; easy to compare. Updated for 2019, but period covered is unclear. Leapfrog was a pioneer in getting ratings in the public eye. The 2020 survey will be shortened due to the Covid-19 pandemic.
Leapfrog named 120 hospitals to its 2019 Top Hospitals list, including 10 top children’s hospitals and 18 rural hospitals. Hospitals must have responded to Leapfrog’s Hospital Survey. Leapfrog Group is a large employer-based organization whose mission is to trigger giant leaps forward in the safety, quality and affordability of health care. The measures emphasize patient safety. Published December 2019.
List of state Insurance Departments for all states. If you like to browse, your state’s site may have additional information about health insurance. These links are provided by the National Association of Insurance Commissioners (NAIC), the organization of insurance regulators from the 50 states, the District of Columbia, Puerto Rico and the other four U.S. territories. The NAIC site has a Consumer Information Source to find medical loss ratios, financial information, and complaint information on the exchange, HMOs and other health insurance plan providers.
The List of Excluded Individuals and Entities (LEIE) is a Medicare fraud prevention site by the HHS Office of Inspector General. It allows consumer to search for a specific name of a person or business to see if they have been excluded from receiving payment from Medicare and Medicaid, due to license revocation, suspension or surrender; program-related fraud; patient abuse or neglect, and other reasons such as default on Health Education Assistance Loans. Exclusions Database contains physicians, nurses, nurses’ aides, hospital employees, pharmacists, nursing home operators and more. More than 72,000 names on the list as of October 2019.
Compare quality at long-term care hospitals for inpatient rehab in the US. Site is called Long Term Care Hospital (LTCH) Compare. These hospitals may also be referred to as long term acute care (LTAC) facilities. Compare 3 hospitals at one time on quality measures for each hospital. Graph view will show the actual performance results. Most data are from 2017 or 2018. Provided by Medicare.gov.
The Medical Fitness Association (MFA) is a non-profit organization that tracks, supports and promotes the industry of medical fitness centers. Facility locator identifies centers worldwide. However, your state may not have any fitness centers that belong to the association.
Medicare inpatient prices for hospitalizations during 2017 are in this difficult to use Excel file. Amounts paid to hospitals by Medicare, on average for FY 2017 hospital stays, are shown. Listed by DRG and provider, consumers can see the Medicare volume for that diagnosis and how much the hospital was allowed as Covered Charges, plus what Medicare payments were. If you can wade through it, you’ll see that total payments were quite often only one-fourth of what the covered charges were – a 75% discount. Hence, the file illustrates how hospital pricing has become meaningless for most people. Some examples are even more astounding. A heart transplant at Cedars Sinai in Los Angeles, had a average charge of $2.7 million, but total payment on average was just over $338,000, 13% of the total charges. That payment level for the 48 cases that year, reflects a hefty 87% discount.
Medicare Ambulatory Surgery Allowed Costs are shown for 25 commonly performed procedures. This file shows 25 procedure payments by Medicare and what they considered the Allowed Amount. It also shows average amounts Medicare paid to Ambulatory Surgery Center (ASC) facilities for selected outpatient surgery such as spinal injection (example: CPT code 62311 Medicare allowed $377, and paid $297), knee arthroscopy (CPT 29881 $1631 allowed), prostate needle biopsy (CPT code 55700 $670 average allowable cost; $530 average cost paid), simple cataract removal & lens insertion ($1679 allowed; Medicare paid $1339), bunion correction ($1825 allowed), crushing kidney stones ($2330 allowed), large bowel endoscopy ($586 allowed, plus $671 for removal of polyps), and more. Includes physician fees and payment to the ASC. Confusing file unless you know CPT codes and can use Excel files. Actual prices or charges are not shown. Unfortunately, this is the best of what’s out there nationally, with state average charges. Old 2012 data published Sept. 2013
Compare the prices (monthly premium average cost) for prescription drug coverage through Medicare (medicare.gov) and see which plans have higher ratings. Uses a 5-star quality rating system that includes member satisfaction survey reports. Part D plans.
NCQA ratings and report card for 2020 on health insurance plans. Compare quality ratings for HMOs and PPO health insurance plans. Aetna, Anthem Blue Cross, Cigna, Humana, Kaiser, United Healthcare – they’re all here, as are many non-profit regional plans. Star ratings and number of enrollees shown for accredited commercial, Medicare and Medicaid plans. Five private commercial plans received the highest possible 5-point star rating: two Capital District Physicians’ plans (CDPHP and CDPHN), Kaiser Foundation Mid-Atlantic States, and two Tufts plans (Tufts Associated HMO and Tufts Benefit Administrators). Thirty-three (33) plans received ratings of 4.5 stars. NCQA (National Committee for Quality Assurance) is a private nonprofit organization that sets standards for quality of care and service that health plans provide to their members. NCQA Accreditation is a nationally recognized seal of approval. Updated for 2020
Free 5-star ratings from Nursing Home Compare for nursing homes that are Medicare or Medicaid certified and provide skilled nursing care. Quality ratings, nursing staffing and CNA hours per resident day, and results from survey inspection reports are updated with 2019 data. If you cannot find the nursing home you’re interested in, the facility might not accept Medicare and Medicaid patients. New feature (red “hand” icon) shows if the nursing home was cited for abuse. Federal fines are listed, but no details available. Check your state reports for additional information. Consumers can also ask the nursing facility to share their reports on resident and family satisfaction. Good nursing homes welcome your inquiry
Directory to help consumers find nursing homes and assisted living facilities. Browse this database of members in the LeadingAge (formerly American Association of Homes and Services for the Aging, AAHSA) to find nursing homes, assisted living facilities, independent living, adult day care and home & community-based services. Shaped by not-for-profit values
State-by-state obesity rates for adults from 2016 to 2018. CDC collected prevalence data shown in the maps through CDC’s Behavioral Risk Factor Surveillance System (BRFSS). Updated September 2019
Medicare reported its average allowed cost for established patients’ physician office visit in 2012: $69 for CPT code 99213 (the most common office visit), $102 for 99214. For new patients, office visit 99203 was $103, and 99204 was $158 Allowed by Medicare. More allowed costs and Medicare payments are shown, including ear wax removal ($49 allowed) and Annual wellness visit for new Medicare enrollees ($165 allowed, and $165 paid by Medicare). Average payments exclude the amount the patient pays directly for co-pays and deductibles. Consumers are expected to know CPT codes and how to use Excel files. 2012 data published Sept. 2013. No updates as of February 2020.
Organ Procurement and Transplantation Network (OPTN) is a secure transplant information database that has all national data on the candidate waiting list, organ donation and matching, and transplantation. Transplant survival rates on a regional basis (1-year, 3-year, 5-year) are compared to national; kidney, pancreas, liver, heart, lung, intestine. Blood type, age, sex and many other comparisons are available. Updated 2020 with 2015 survival data. Volume of transplants by transplant center updated year-to-date 2020.
Hospitals with Palliative Care programs are listed in this directory by the Center to Advance Palliative Care (CAPC) in conjunction with the National Palliative Care Registry. Palliative care specializes in the relief of the pain, symptoms and stress of serious illness; it can be provided along with curative treatment.
Find out what Medicare paid for certain types of office visits and procedures in 2012. Average doctor’s price is NOT SHOWN, but only the allowed amount determined by Medicare, and how much Medicare paid on average (for every state). Must know how to use Excel files and billing code knowledge would also be helpful. Medicare paid $49 for a 99213 office code (15 minute office visit for an established patient) and $73 for a 25-minute office visit, and just $101 for a 60-minute visit (est. patients). If the patient was new, Medicare paid $73 on average for a 30 minute visit, and $116 for 45 minutes. Medicare’s annual wellness visit was paid at $165 for new enrollees, then $111 for subsequent annual visits. The most common EKG was paid at $14, ear wax removal at $36, pneumonia or annual flu shot at $23. Difficult file to use. Terribly dated; last updated Sept. 2013
Find the Allowed Medicare amounts (rather than prices) in the Ambulatory Surgery file for 25 Common high volume outpatient surgical procedures in an Ambulatory Surgery Center (not hospital-based). File shows what Medicare paid during 2012 for cataract surgery, different types of endoscopy, spinal injections, some hernia repairs, carpal tunnel release, kidney stone crushing, prostate biopsy (avg $530 paid on $670 allowable charge; full charge is not shown), correction of bunion, and more. Uses CPT codes, and all states are listed. Difficult file for consumers to use unless familiar with Excel. Terribly dated; last updated Sept. 2013. Federal government could show its commitment to price transparency by updating this file, and showing full sticker prices.
Find out how a sample of 6000 physicians rate Blue Cross, Aetna, CIGNA, Harvard Pilgrim, Medical Mutual of Ohio, Kaiser, Oxford, Humana, HealthNet and UnitedHealthcare health insurance companies (payers). On a scale of 1 (low) to 5 (high), the best can only muster a 3.3 overall rating. Scores indicate how easy a health plan is to do business with. By Medscape. Last Pub. 2014. No updates available
Premier selected 8 hospitals to receive the 2019 QUEST® Award for High-value Healthcare. They achieved top performance in all five of the areas measured: cost, inpatient and outpatient evidence-based care, safety, patient experience and unplanned readmissions.
Find a list of Quality Improvement and Innovation Organizations – QIOs. The mission of the QIO program is to improve the effectiveness, efficiency, economy, and quality of services delivered to Medicare beneficiaries. It has been modified to incorporate Quality Innovation Networks and complaints on behalf of patients and beneficiaries. Find a Quality Improvement Organization here, searchable by state. Updated 2020.
Find rehabilitation hospitals that are accredited by CARF – The Commission on Accreditation of Rehabilitation Facilities. CARF offers the ability to do an online search for accredited facilities with specific rehab programs you may be interested in. Includes Behavioral Health, Pain Management, Brain Injury, Spinal Cord, Physical Rehab, Aging services, and more. Search engine is either simple (just zip code) or very complicated because of its detail, abbreviations and multiple choices
Have you ever wondered where the nearly 28 million people under age 65 and without health insurance are located, after the Marketplace Exchange went into effect? Kaiser Family Foundation shows the number uninsured (nonelderly, ages 0 to 64) by state, in 2018. Ten states make up 60% (over 16 million) of the US uninsured under 65: Texas, California, Florida, Georgia, North Carolina, New York, Illinois, Arizona, Ohio and Virginia. KFF statehealthfacts.org updated 2019
Compare state by state map and table for percent of smokers who tried to Quit Smoking. Overall 57% tried to quit, US-wide according to the most recent (2018) data, down 2 percentage points from 2017. What is happening in your state? Puerto Rico and the District of Columbia (DC) had the greatest percentage trying to quit. Montana and South Dakota were the lowest in percent of smokers trying to quit smoking; though still, at 51%. Breakouts by racial groups are shown for each state. From the Kaiser Family Foundation State Health Facts.
List at healthfinder.gov – Links to all state health departments, compiled by the US Department of Health and Human Services
Identifies 27 states and Wash. DC that require adverse event reporting. Prepared by the National Academy for State Health Policy, a non-profit, non-partisan organization dedicated to helping states achieve excellence in health policy and practice. Pub. Dec. 2007. The 2014 updated report (pub. Feb. 2015) identifies 26 states and DC, but was not available online in 2019.
Surgeon Scorecard for knee, hip, gallbladder, spinal fusion and prostate surgery shows complications for each hospital and doctor. It compares individual surgeons’ complication rates (risk-adjusted) for Medicare patients having one of 8 types of inpatient surgery: hip or knee replacement, laparoscopic gallbladder removal, cervical (neck) or lumbar spinal fusion (either posterior or anterior technique), and prostate resection or removal. Analysis by ProPublica looked at billing records from 2009 to 2013. Numbers of cases shown are MEDICARE-ONLY (although the column title omits that point), and require at least 20 cases for a doctor’s rate to be shown. Physician’s rate combines his/her Medicare cases at all hospitals. Website was somewhat controversial in 2015. Tool is easy to use. Unfortunately, data have not been updated by ProPublica.
View the list of top critical access hospitals (CAHs), rural and community hospitals in the U.S. Compiled by iVantage and Chartis Health for 2020. Methodology is not readily identified.
From usatopdentists.com, comes this list of top dentists in every state who received higher ratings in surveys of general dentists and specialists in all states. Search city-specific or statewide within a specialty (including General Dentistry.) Details on dates, methods and how many dentists responded to the survey are unclear (see Selection Process)
Waiting list numbers of people waiting for a transplant: Kidney, pancreas, liver, intestine, heart, lung transplants. In June 2020, about 93,000 people were waiting for a kidney (19,000 in California alone) and 12,000 for a liver. Survival rates shown by age, sex and ethnicity.
Find hospital trauma programs that are Verified Trauma Centers by ACS. Level I, II and III Trauma Centers are listed here, by state (and other international locations), at the American College of Surgeons’ (ACS) website. Trauma Center designation is a voluntary process that hospitals may choose to pursue for Adult and/or Pediatric care. Level I is the highest level of five levels. A description of what’s expected to be available at each level can be found at amtrauma.org.
USNews.com identifies America’s Best Hospitals on the 2019-2020 Honor Roll. Mayo Clinic (Rochester, MN), Massachusetts General Hospital (Boston) and Johns Hopkins (Baltimore) top the list of 21 US hospitals identified (from 4,653 nationwide), who rank favorably in multiple specialties. Check the details to see specifics for a certain illness, since one hospital may not be ranked (by US News) as best in everything. Methodology report shows how the hospitals scored. Survival rate (30-day mortality rate) for Medicare patients and Patient Safety are two factors used in the rankings for most of the specialties. Reputation used for Ophthalmology, Psychiatry, Rehabilitation and Rheumatology. 2019-2020 ratings use Medicare data from 2015-2017
Best Hospitals Cancer rankings for 2019-2020 from usnews.com. US News & World Report again named University of Texas MD Anderson (Houston, TX) and Memorial Sloan-Kettering (New York) as its 2019-2020 leaders of the top 50 hospitals for cancer care in the US. Scoring includes survival (30-day mortality), professional reputation, designation from the National Cancer Institute and other factors. Minimum number of Medicare cases was 227 (over 3 years, 2015-2017).
Who are the best hospitals in cardiology and heart surgery for 2019-2020, according to the usnews.com rankings? The top of the Cardiac specialty list are Cleveland Clinic (Ohio) and Mayo Clinic (Rochester, MN). Top 50 hospitals ranked. See if there is one in your state. Rankings include survival ratings using Medicare data from 2015 to 2017. Hospitals ranked higher if they participated in public transparency reporting by the medical professional societies. Minimum volume of 1,931 Medicare cases over 3 years.
US News & World Report’s top pediatric hospitals listed for cancer; cardiology and heart surgery; diabetes and endocrinology; gastroenterology (digestive disorders) & GI surgery; neonatology; nephrology (kidney); neurology and neurosurgery; orthopedics; pulmonology (respiratory problems) and lung surgery; and urology. Honor roll of 10 hospitals is led by Boston Children’s, Children’s Hospital of Philadelphia, and Cincinnati Children’s tied for third with Texas Children’s in Houston. List called Best Children’s Hospitals updated June 2019. Detailed hospital scores for individual measures such as survival, are in the Methodology report
What are the best Medicare Advantage Health Insurance companies for 2020, according to usnews.com? Medicare Advantage health insurance companies are shown by state if their plans – together, across the state – have achieved an average of 4.5 of 5 stars by Medicare. Uses Medicare’s 2020 Star Ratings. Advantage plans combine Part A and Part B. Not every state has a highly rated company. For example, there is no top Medicare Advantage company in Arizona…home to nearly 1.3 million seniors. Announcement made in October 2019 by U.S. News & World Report
USnews.com lists Best Medicare Part D (drug) health plan rankings for 2020. Just 12 companies had plans that earned on average, 4.5 or 5 stars from Medicare for Part D (drug) coverage. Eleven companies are some form of Blue Cross drug plan, the other is WPS Health Insurance in Wisconsin. Uses the CMS Star Ratings.
Compare VA hospitals and clinics on wait times, patient satisfaction and quality scores. Detailed ratings on all of the Veterans Health Administration hospitals using current data. Easy to compare waiting time and access for VA clinics in your area, crossing state lines. Very quick to find how long you might have to wait for primary care, mental health, or other specialty appointments. Satisfaction ratings, and ratings of outpatient care (depression, heart care, diabetes, cancer screening, smoking cessation, flu vaccination). Access and waiting times are updated for 2020. For comparisons to private hospitals and nursing homes, the VA provides links to the federal HospitalCompare and NursingHomeCompare sites. Website is very user friendly for all types of VA clinics, hospitals, nursing homes. Editor’s Pick.
Find VA hospital and medical facility inspection reports. The Veterans Affairs Office of Inspector General (OIG) makes its VA Medical Center inspection reports available online. Types of reports include audits, healthcare investigations, inspections and more. Outpatient clinics and nursing homes are included. Listed by date; use filters on right within each category to select location. Updated 2020.
Easy to use directory to look up a VA medical facility. The Department of Veterans Affairs provides a convenient search tool to find the location of medical facilities such as hospitals and clinics. Facilities in the US, American Samoa, Philippine Islands, Guam, Puerto Rico and Virgin Islands are all listed.
Walmart has implemented a limited-scope program for nearly 100 generic drugs (with multiple drug/dose combinations) offered at a $4 price for a 30-day supply in most states. Most drugs on the list may also be purchased at $10 for a 90-day supply. Available in all states except North Dakota. However: Due to FAIR PRICING laws in CA and MN, many drugs will carry higher prices, or may not be available. Other states previously listed with possibly higher prices, included HI, MT, PA, TN, WI and WY. Prices apply to Sam’s Club pharmacies also. Revised price list dated Nov. 2018.
Watson Health (formerly Truven Health Analytics) list names top 100 hospitals in categories according to size and teaching status using Medicare data primarily from 2017 and 2018, other publicly reported (at HospitalCompare) patient satisfaction scores and results such as mortality rates, readmissions, ER times and spending. While no data are shown for individual hospital performance, Watson Health makes a case that as a group these hospitals outperform their peers in quality and efficiency (lower expenses). Free report shows winners’ names only; some winners received the Everest Award for also improving at the fastest rate over the long term. Methodology examines survival, complications and readmissions, patient recommendations; efficiency and profitability. Published June 2020 by IBM Watson Health.
Watson Health (formerly Truven Health Analytics) 2020 selection of the top 50 cardiovascular hospitals. Top selected hospitals with significant heart care programs are listed in categories: teaching hospitals with cardiovascular residencies, teaching hospitals without such residencies, and community hospitals. List only, organized by state; study primarily used Medicare data from 2017-2018. It examined both clinical outcomes (e.g. survival or mortality, complications, readmissions) and efficiency measures. Released November 2019 by IBM Watson Health.