Healthcare.gov reports the final rate increase or decrease for Jan. 1, 2019, by name of health insurance plan for individual policies or small group health plans on the health insurance exchange. Search by state, and use December 2018 to January 2019 to see increases. Updated for 2019
From usatopdentists.com, comes this list of dentists 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)
Find performance levels of nearly 1400 community health centers by state, on clinical measures: diabetes, hypertension, prenatal care, low birth weight, asthma, childhood immunizations, depression screening, weight management, dental and cervical cancer screening. UDS data from 2017
Estimates of the number and percent uninsured under age 65, by state and county for 2016, provided by the U.S. Census Bureau. Small Area Health Insurance Estimates (SAHIE) released March 2018. Once you’ve located your counties of interest, click on it to see the actual numbers and recent trends. Remember 2014 was the first year subsidized insurance was available on the health insurance exchange. Uninsured rates have declined since then.
Web site from US Office of Personnel Management (OPM) helps federal employees and others compare the benefits, member satisfaction, and employee costs of up to 4 health insurance plans at one time. Search by zip code; choose local plans and/or national plans. Convenient and current. The amount that taxpayers and government institutions pay toward the total health care premiums is no longer readily available
HealthGrades gave excellence awards to hospitals in 13 states for top quality in Bariatric surgical procedures such as gastric bypass and Vertical Sleeve Gastrectomy; 13 states were studied (CO, FL, IA, IL, MD, NY, NV, OR, PA, RI, TX, WA and WI), with seven states having excellent hospitals. Volume, survival rates, complication rates and length of stay were studied using 2011-2013 data. Pub. 2015
HealthGrades lists its 5-star hospitals (Excellence Awards) in women’s care defined as labor & delivery maternity ratings, gynecologic procedures (such as hysterectomy) and Ob-Gyn services. Uses 2013-2015 All-payer from 17 states for the 2017 awards in selected states.
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. Medical experts recommend that babies need at least 39 completed weeks to develop fully, which includes having a fully developed brain and other organs. Some hospitals do not report. See Maternity results on the 2017 hospital survey by the Leapfrog Group
Compare side-by-side (5 measures at a time) over 500 participating medical groups, hundreds of clinic locations and urgent care centers in Minnesota, Fargo, Grand Forks, Sioux Falls, and some WI communities for diabetes, knee replacement, vascular care, mental health (depression), cancer screening, controlling high blood pressure, heart (coronary artery) disease, asthma, vaccinations, appropriate care for children with colds and sore throats and more. Some clinics also have patient satisfaction scores. Medical groups include Allina, Altru, Apple Valley, Aspen, Avera, Brainerd, Children’s Physician Network, Dakota Clinic, Edina, Fairview, Fergus, Grand Itasca, Gundersen, HealthEast, HealthPartners, Lakewood, Mankato, Mayo Clinic, North Memorial, Northfield, Olmsted, Park Nicollet, Ridgeview, Sanford, St. Cloud CentraCare, St. Luke’s, St. Mary’s Duluth Clinic (Essentia), Stillwater, United, University of Minnesota, Winona Health Services, and more; OB-GYN clinics and Orthopedic clinics. Report by MN Community Measurement (founded by the MN Medical Association and seven non-profit health insurance plans). Annual data, but report doesn’t specify what year (unclear why that is a secret). Otherwise, the interactive format is easy-to-use.
Find how much physicians charge for over 100 professional services in Minnesota, ND, SD, WI through Minnesota HealthScores’ Cost Report feature. Compare prices over 150 participating medical groups, and hundreds of clinic locations in Minnesota, and some border communities, for doctor office visits, lab tests, colonoscopy, endoscopy, minor office surgical procedures such as ear wax or wart removal; immunization, psychotherapy. Obstetric services, including inpatient delivery. Medical groups include Allina, Altru, Apple Valley, Aspen, Avera, Brainerd, Children’s Physician Network, Dakota Clinic, Edina, Fairview, Fergus, Grand Itasca, Gundersen, HealthEast, HealthPartners, Lakewood, Mankato, Mayo Clinic, MeritCare, Innovis, North Memorial, Northstar, Olmsted, Osceola, Park Nicollet, Regina, Ridgeview, Sanford, St. Cloud CentraCare, St. Luke’s, St. Mary’s Duluth Clinic, Stillwater, United, University of Minnesota, Winona Clinic, and more; OB-GYN clinics, Report by MN Community Measurement. Does NOT include facility charges which are in the thousands for colonoscopy or childbirth. Interactive easy-to-use format. Costs shown are claims through BCBS, Health Partners, Medica, and Preferred One in 2017. Unclear if it’s price before or after discounts
The Wisconsin Office of the Commissioner of Insurance (OCI) published the 2017 health insurance company premium rates for small employers (2 to 50 employees) for group health insurance policies. Rates for a sample Silver Plan (80/20 with approx $3000 deductible) varied by company and city. Aetna’s silver plan for a 50 year old non-smoker was $720/month in Superior, but $856 in Milwaukee. Anthem Blue Cross ranged from $665/month (Wausau) to $930 (Prairie du Chien). Gundersen had a flat $544 for 50-yr olds in their western WI markets. Dean, Group Health, Physician Plus, Aspirus, Security, United Healthcare, Unity, WPS and others are listed
Compare the care provided by physicians and doctors in regions across WI. Comparisons are shown by clinic office location. Simple aggegate scoring, but somewhat dated. Sponsored by WHIO (Wisconsin Health Information Organization) with support from WCHQ Collaborative, WI Hospital Assn, DHSS, and WI Medical Society; 2013-2014 data, not as current as WCHQ
Average 2016 charges in WI for 20 common ambulatory surgery procedures, such as Colonoscopy (6 codes), Endoscopy, Biopsy, Spinal Injection, Cataract & Lens ($7455 hospital average), outpatient Knee surgery/arthroscopy ($12,191), Carpal Tunnel ($6279), Ear Tubes, and more. Volumes for each hospital and surgical center are shown for top 20 only. Go to Table 28 for a longer list of 40 procedures including colonoscopy ($4934 average) and gall bladder removal (laparoscopic cholecystectomy at $16,206). Chapter VII compares average prices (along with median charge and volume) at each hospital for twenty 2016 ambulatory surgeries. Prices do NOT include surgeon and physician fees, which may cost thousands of dollars and could double prices shown. Consumers should add inflation to estimate 2018 facility prices. Scroll to bottom of page for Chapters VI and VII Ambulatory Surgery, published by WHA Information Center August 2017
View graphs comparing rates for breast cancer screening, cervical cancer screening, diabetes care / eye exams, follow-up for mental illness, time spent with physician, children’s visits to primary care providers, and overall rating of health insurance plans: Dean, Group Health Coop, Gundersen Lutheran, Humana, Medical Associates, Medica, MercyCare HMO, Network, Physicians Plus, UnitedHealthcare, Unity, WPS and more. 2015 data, updated January 2017 by State of WI, OCI
List of hospital-specific rate increases for 2018 and prior year comparisons. When updated by the WI Hospital Association’s Information Center (4-3-2018), increases for 2018 were averaging 4.7% (compared to a CPI Index of 2.1%). The average hospital price increase during 2017 was 3.7%, about the same as in 2016. Most recent CPI Index for 2017 ended at 2.50%
Maintained by the WI Dept. of Safety and Professional Services, this site allows consumers to check their doctor’s licensing information (to see if still active), and any disciplinary actions called Orders. Full report of discipline-related events can be accessed, so consumer can judge for him/ herself. Physicians are listed under Medicine and Surgery (select DO or MD). Licensed Chiropractors, Acupuncturists, Dentists, RNs, etc. are also at this web site
Partial List of top dentists in seven specialties (such as endodontics, oral surgery, orthodontics, pediatric dentistry; about 77 listed for General dentistry; 8 pediatric dentists.) Local dentists were surveyed to pick their favorite dentists in Madison, WI. Unclear how many responded to the survey. Published 2017 Madison Magazine
Madison Magazine asked Dane County physicians to name top doctors in 73 medical, pediatric and surgical disciplines that they would recommend to their family and friends. Generally, 3 to 6 physicians per specialty are listed. Such a list is reputation-oriented and based on personal experience, and does not necessarily reflect actual performance data. Number of respondents to survey is not shown. As with all Top and Best physician lists, you’ll want to check multiple sources. Published March 2016
Four categories of WI Assisted Living facilities are provided: Adult Day Care, Adult Family Home, Community Based Residential Facility (CBRF) and Residential Care Apartment Complex (RCAC). Each organization and facility has its own report that includes an Inspection Summary; No side-by-side comparisons. However, this link shows profiles by individual county to aid your search
Compare hospital quality performance and patient satisfaction ratings for 125 hospitals in WI. Topics: heart attack, heart failure, pneumonia, surgical infection prevention and survival for hip, knee surgery, heart, vascular, other cardiac, colon surgery and hysterectomy; patient safety practices, incidental appendectomy rate; deaths data. See how many patients would definitely recommend the hospital. Most data are from 2016-2017. Wisconsin Hospital Association makes quarterly updates. Even though the clinical topic list is sketchy (such as Bones and Digestive), WHA receives Editor’s Pick for going beyond CMS measures, for showing all hospitals side-by-side, consumer ease in getting a free comprehensive quality report for one hospital, staying current, and showing comparisons to the benchmark best in the state
Compare WI physician clinics on measures related to satisfaction with getting a timely doctor’s appt.), patient recommendations on clinics; scores for diabetes, heart care, high blood pressure, smoking & osteoporosis screening, pneumonia shot, screening for Breast Cancer, Cervical Cancer & Colorectal Cancer; Ischemic Vascular Disease care, BMI, Depression screening and more. Includes Affinity, Aspirus, Aurora, Bellin, Ascension Columbia St. Mary’s and Wheaton, SSM Dean, Mayo Clinic Eau Claire and Franciscan, Froedert, Gundersen Clinic, Marshfield Clinic, Mercy, Meriter, Prevea, Primary Care Associates Appleton, ProHealth, ThedaCare, UW Health and others. Some medical groups report scores by individual clinic location. The Sort-by-Rank option helps you see better performers on the top of your list for some items. Easy to read reports by WI Collaborative for Healthcare Quality; 2016 and 2017 data
WCHQ is a voluntary consortium of organizations (doctors, hospitals and health insurance plans, supported by community businesses) publicly reports and explains performance measures to improve the quality and affordability of healthcare in Wisconsin. They are a national leader in the public reporting of healthcare quality measures. HQ in Madison WI area
Compare 19 WI hospitals on cardiac performance ratings. Five measures related to cardiac bypass CABG infections, complications, deaths; quickness in opening up arteries in a heart attack; and in-hospital mortality for cardiac cath patients. Data are for 2016. WCHQ report
Lists Hospitals and health care facilities that are licensed to serve Wisc. residents. Includes assisted living, outpatient surgery centers, kidney dialysis providers, home health agencies, hospice, outpatient rehabilitation, rural health clinics, swing bed hospitals and nursing homes. This website also has a roster list of Community Based Residential Facilities (CBRFs) that shows the approximate range of prices and services offered. The list may be more helpful than the information shown in Provider Search. WI Department of Health Services. Consumers can also call toll free 1-800-642-6552 to file complaints. Updated 2018.
Find typical charge for common visits to emergency departments or hospital-based urgent care. Examples: urinary tract infection (UTI), or nausea and vomiting or teeth problems. Shows median (middle) price for ER (2017-2018) WITHOUT the physician’s fee, and how many cases the hospital treated. If the hospital has on-site urgent care, it will show that price also. Example: Madison area (Dane County) ER cost for UTI was $2863, but much lower at $619 in urgent care settings. Free-standing community Urgent Care clinics are not included in these prices. Mercy Hospital in Janesville charged $1607 in the ER for UTI, but just under $700 median in its urgent care service. WI Hospital Association’s PricePoint makes comparing hospital prices possible. Compare hospitals downtown vs. those in the suburbs.
Annual premiums and deductibles (2018) for employee health insurance in various metro markets averaged $10,043 per year for single coverage. Citizen Action of Wisconsin, a coalition of individuals and organizations (such as AFSCME locals, AFL-CIO, WEAC, WI Farmers Union), reports health insurance cost in 18 metro regions, including Twin Cities. Rates in Eau Claire ($10,908 per yr, single) were 20% higher than Madison rates ($9096 per yr.) Most areas exceeded $10,00 single. Health plan costs shown for Twin Cities, Oshkosh, Green Bay, Appleton, Manitowoc, Sheboygan, Fond du Lac, Janesville/Beloit, Wausau, Stevens Point, La Crosse, Superior, Eau Claire, Kenosha, Racine, Milwaukee, Dubuque, more. Uniform benefits package was used for all areas, however the report does not specify what type of benefits and deductibles were included. The report also does not indicate whether the rates were adjusted for regional differences in age, or healthy behaviors. Shows annual inflation pre-ACA (2000 to 2013) compared to after ACA (2014-2018), with post-ACA so very much lower. However, this summary can be misleading. In 2018, large group rates went down 5%, while individual inflation was up 51% (up 60% in Madison, doubled in Green Bay), and small group inflation was 10% compared to 2017. Large Group information reflects government employee rate paid by State of Wisconsin’s Group Health Insurance Program (GHIP)
Compare all WI hospitals (side-by-side) on their survival rates for stroke, hip fracture and GI Bleeding. Wisconsin Hospital Association report Deaths Due to Illness shows most hospitals performed As Expected, with a few significantly Worse, or Better than the others. Deaths and volume data from 2014, the latest available as of March 2019
Compare 86 WI hospitals (side-by-side) on their survival rates for AAA Repair, Craniotomy, CABG heart (cardiac) bypass, PTCA angioplasty, CEA endarterectomy, and hip replacement surgery. Wisconsin Hospital Association report Deaths During a Procedure shows most hospitals performed As Expected, with a few significantly Worse, or Better than the others. Source data (not updated) from 2014 reported as of March 4, 2019.
Two-page summary for each WI hospital’s number of births, and other types of inpatient stays: Stroke, Knee replacement (APR-DRG 302), hip replacement (301), COPD, Pneumonia, Heart Failure, Bowel surgery, Septicemia, Psychoses, etc. Average (facility) charges for 2017 also shown; excludes physician and surgeon fees. Full report also shows statewide median charges. Released by WHA Information Center July 2018
Median charge and length of stay for common hospitalizations including maternity and newborn births, hip or knee replacement surgery, gallbladder removal, heart surgery, angioplasty, arrhythmia (irregular heartbeat), valves, cardiac cath, pacemaker, pneumonia, bipolar and other mental health, stroke, back care, asthma, COPD, rehab; kidney, heart, lung or other transplant; hysterectomy, prostate surgery, bowel surgery & more. Also shows inpatient volumes if you click on more detail. From WHA Information Center, part of the Wisconsin Hospital Association WHA Information Center. Surgeon fees NOT included, nor are dates shown. Compare hospitals by city (anywhere in the state by adding cities). Wisc. Hospital Assn. created the PricePoint System now used in other states. This version of Pricepoint has been modified to be payer-specific, although gross charges (sticker price) should be the same for all patients. Must watch a video before proceeding to see the prices; you may also need specific medical information about the procedure in order to select the price you are interested in.
Scroll to the bottom of the page to search by Wisconsin city or county. Consumer Information Reports contain information on nursing home staffing ratios and staff turnover, survey inspection findings and deficiencies. Information on Facilities for People with Developmental Disabilities also found at this site. Data prepared by the WI State Dept. of Health Services for the most recent full year. Data updated 2017
Compare outpatient and ambulatory surgery volume and charges for colonoscopy, cataracts, eardrum surgery, shoulder or knee surgery, carpal tunnel surgery, removal of tonsils & adenoids, appendectomy, breast biopsy, endoscopy, gallbladder (cholecystectomy), upper GI, heart catheterization and more. Compare hospitals and surgical centers. Typical (median) price in county and statewide Wisconsin median prices shown, but no dates are provided for reference. Prices exclude surgeon and other doctors’ fees which may double the numbers you see here
Mayo Clinic and Mayo Clinic Health System reports its ratio of observed deaths to expected deaths (x 100) for its Minnesota, Wisconsin, Florida and Arizona hospital operations, from 2014 to 2017. Mayo Rochester is NOT shown separately. Usually the comparison is relative to 100, so despite the confusion, it’s interesting to see this level of transparency. Look for results under 1. (Over 1 is not a great sign). Mayo’s target is 0.71 or lower. Most facilities met that target; all were were under 1.0
Main Street Medica provides average cost ranges by hospital or clinic name, for 19 common hospital inpatient stays, 29 outpatient surgery procedures, over 50 diagnostic imaging tests, nearly 80 types of office visits; medical equipment, prosthetics, & supplies for diabetes & ostomy care, chiropractors. Also gives comparative costs for a few generic vs. prescription drugs. General range of lab test costs are in the Choosing Quality Care section. Includes Minnesota, Fargo, Bismark and Grand Forks, ND, Sioux Falls, SD and many WI hospitals and clinics. Reported price estimates apply to Medica Choice Network services, not necessarily the general public. Dates of prices are not disclosed.Links to quality reports from MN Health Scores and Hospital Compare. Site is very responsive and easy to use if you search by Procedure, Disease or Condition. Medica is a Twin Cities-based NCQA-accredited health insurance plan serving 1.2 million people.
ProHealth Care (Waukesha and Oconomowoc, Wisconsin) provides online comparisons of charges for certain common inpatient hospitalizations such as maternity, and hospital prices for the 75 most common inpatient stays and the 75 most frequent outpatient surgical procedures. Very useful because the median charge is more current (2017-2018) and it shows what commercial insurance usually pays, and what Medicare usually pays. There is a huge difference. Find charges for procedures such as cataract surgery, colonoscopy, hip or knee replacement, hernia repair, ACL repair. carpal tunnel, tonsillectomy (removal of tonsils), surgery for gall bladder (cholecystectomy), rotator cuff, breast biopsy, endoscopy and more. Prices do not include surgeon or other physician fees
Wisconsin Hospital Association 16-page report shows hospital vacancy rates in 2016 were between 8% and 10% for Advanced Practice Nurses, CNAs and Physician Assistants. All others were under 8%, with RNs just under 6%. Additional info about workforce age, and Surgical Techs, LPNs, CRNAs, respiratory therapists and more. Published October 2017
Report prepared by UW Population Health Institute showing where each county in Wisconsin stands with regard to health care, health status and outcomes, access to care, healthy behaviors, socioeconomic factors, and physical environment. Clinical care (which measured rates of uninsured, supply of providers, preventable hospitalizations, diabetic screening and mammography rates) ranked Ozaukee County the highest; Crawford County was the lowest. Pub. 2019
Compare your county health status to the rest of your state, on the latest results for smoking, obesity, alcohol use, preventable hospital stays; primary care, dentist and mental health provider rates, percent uninsured (as of 2016), 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 report on trends in health statistics from the publication Health, United States, 2016 edition, by the National Center for Health Statistics (NCHS). Report chartbook contains text and figures showing long term trends in the health and healthcare of Americans; 1975 to 2015; 114 tables. Published online by CDC May 2017; 488 pages
Compare states on health status, health insurance coverage, costs, minority health, and more. From the Kaiser Family Foundation; Dates vary from 2014 to 2017
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: Vermont, Minnesota, Hawaii, Rhode Island and Massachusetts, Colorado and Iowa. Data periods vary; most are current to 2015; one measure to 2013; 44 measures; published March 2017
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
State Health Policy Survey Report provides a snap shot of the scope and operations of state government adverse event reporting systems as of 2014. At that time, only 6 states (CO, MN, NH, MA, CT and IN) reported facility-specific data to the public. Not much change since 2007. 31 pages, published by National Academy for State Health Policy (NASHP), Portland, Maine, January 2015
The nonprofit Accreditation Association for Ambulatory Health Care (AAAHC) currently accredits over 6000 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 A Fib and cardiac cath. 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, home health/hospice, laboratories, some nursing homes (called nursing care centers) & assisted living centers, and other health care services. Click on View Report and National Quality Improvement Goals to see actual scores for acute care hospitals 2016-2017
The Healthcare Facilities Accreditation Program (HFAP), founded by the American Osteopathic Association, lists names of acute hospitals and their laboratories, critical access hospitals, office-based and other ambulatory surgery centers; behavioral health, and primary stroke centers, that are accredited under the HFAP program. Competitor to the Joint Commission
List of acupuncturists 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
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 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 prices for about 80 outpatient ambulatory surgery procedures done in hospitals in 2007 (excluding surgeon’s or other physician fees.) Average colonoscopy & biopsy price then was $2369; upper GI endoscopy $3131; cataract & lens was $4870; tonsillectomy $5286; knee cartilage $7357; hernia repair $8187; outpatient gallbladder removal (cholecystectomy) $10,838; breast biopsy $3863; lumpectomy $7458; ear tube surgery (myringotomy) $3547; D&C $6366; arthroscopy $8970; incontinence procedures $9929; vericose veins $8459; bunionectomy $7699; wrist fracture $7807; $4770 for circumcision. Consumers will need to adjust the 2007 prices to estimate 2018 costs; possibly add 35-40% for a rough estimate. Overall average was $6100, compared to nearly $40,000 for inpatient surgery. AHRQ Statistical Brief #86 published February 2010 unfortunately still has not been updated. No longer Editor’s Pick
HealthGrades choice for the top 50 hospitals and 100 best in the US, based on clinical quality for Medicare patients over 3 years ending 2016. List shows which hospitals have held clinical excellence for 6 years (top 1%), and those for 3 consecutive years (top 2%). They 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)
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 Certified on the left of the certification matters.org page (sponsored by abms.org). Registration (free) is required, and well worth it. We encourage visitors to use the site
Database to help you find a dentist who belongs to the American Dental Association. Shows only name, location and contact information
Charges and average costs for the 20 outpatient Ambulatory Payment Classifications (APCs) representing the highest Medicare outpatient payment to each hospital (excluding critical access hospitals). List varies by hospital. May include: 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 Outpatient Utilization Statistics. Also shown: inpatient market share by local zip code; net income. Link is to the Free Hospital Information
Typical cost for home health aide in a licensed agency was $21.50 per hour nationwide (median). A private one bedroom Assisted Living facility cost more than $45,000 per year ($3750 per month). Semi-private nursing home median room rate was $235 per day, with Alaska at a whopping $800. All states listed; average adult day care and homemaker rates also shown. Survey by Genworth Financial (CareScout) in May and June 2017; published August 2017
The 2017 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 now exceed $7000 or even $8000 (Alaska). Lowest rate $4901 was in Provo-Orem UT. Average employee-plus-one premiums were over $10,000 across the US. Family premiums were best in San Antonio-New Braunfels TX at $13,813; but topped $22,700 in Anchorage, Alaska. Average Single contribution was under $2000 across the US. Coverage levels and plan design will vary
Find a treatment clinic or facility for mental health, alcohol, drug, and substance abuse treatment. 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. May filter out smoking or nonsmoking locations. Site by the federal Substance Abuse & Mental Health Services Administration (SAMHSA).
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, 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 and spine surgery. Quality criteria can be found from the home page. Fertility care distinction to launch Jan. 1, 2019. Interactive database; updated 2018
Lists of top 10% hospitals in specialties such as bariatric surgery, cancer care, cardiac surgery, inpatient gall bladder surgery, GI care, general surgery, hip fractures, hip or knee joint replacement, organ transplants, spinal fusion, stroke care, and more. Top hospitals listed by nation, state or region.Categories include Medical Excellence, Patient Safety and Patient Satisfaction. Consumers can choose Medical Excellence results for Overall Surgical Care only. 2019 report covers Medicare claims data and HCAHPS patient satisfaction from 2014 to 2016, or in some cases to 2017. Announcing award-winning hospitals may require a license fee to be paid. CareChex is a division of Quantros, a for-profit software solutions company, which appears to be a competitor to HealthGrades
Searchable list of nearly 9000 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 May 1, 2018, just over half of facilities had been inspected, and nearly 87% had no violations, which was a little lower than last year.
List of federally funded community health centers that provide primary 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
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. Updated January 17, 2019
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
WhyNotTheBest.org is a helpful website to check hospital ratings, although data are a bit old. Shows trends and in many cases which hospital has the best performance in the country. Currently using 2015-2016 data for most measures. Some measure are older. Heart care, pneumonia, surgery, patient satisfaction, survival rates (mortality) and more. 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 project, run by Center for the Evaluative Clinical Sciences at Dartmouth Medical School, highlights the wide variations in how health care is delivered across the United States. Online tool provides comparisons by geographic region (HSAs or HRR) for Medicare healthcare use (data through 2014). While the tool is relatively easy to use, the conceptual understanding of the reports requires technical sophistication
Compare services and ratings on kidney dialysis facilities in any state or US territory. 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. Resources on kidney failure and end stage renal disease (ESRD) also linked
This 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
Comprehensive 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 rate anyone called Doctor (such as chiropractors and dentists) in the US and selected countries at this site: RateMDs.com. As of May 2018, 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.
Find out about ART clinics (Assisted Reproductive Technology) in the US and Puerto Rico, in this 586-page report by the CDC in conjunction with Reproductive Medicine societies. Shows success rates by age of woman, and both fresh and frozen embryo transfers. One-page summaries for each of 464 fertility clinics reporting 2015 data. Nationally, about 55.6% of fresh embryo transfers resulted in live births, with 42.3% of frozen embryos resulting in live births. Success rates decline with age of woman. Percentage of transfers resulting in pregnancy were 65.9% for fresh embryos and 52% for frozen. Pub. Oct. 2017
Federal government website at medicare.gov lists physicians by city (the zip code feature is not reliable yet) and specialty, including podiatry. Not too much information, usually less than you get at a state’s licensing site, even after 7 years since site launch. Maybe in the future it will contain useful quality comparisons. Psychologists, social workers, therapists, nurse practitioners, physician assistants & audiologists are not included
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, laser hair removal, liposuction, nose reshaping (rhinoplasty) or tummy tuck. Web site by the American Society for Aesthetic Plastic Surgery (ASAPS)
Search for what is here referred to as an Aging Life Care Professional (formerly geriatric care manager). The Aging Life Care Association 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.
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. From the American Society of Clinical Oncology (cancer.net) ASCO website
Members of the American Orthopaedic Foot & Ankle Society are listed in this searchable database. Only doctor’s name and contact information available. Check other sources for education and experience
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. From HHS at US government
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 are conducted on GuideStar.
Use the Find and Compare hospitals tab to view patient satisfaction survey ratings and opinions by hospital inpatients across the US. Side by side comparisons for 3 hospitals at a time, 2017-2018 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
Annual report (Jan. 2018) identifies top-rated distinguished hospitals (top 5%) from evaluating Medicare data from 2014 to 2016; 38 states had hospitals that ranked in the top 5%. Mortality results (survival rates) and complication rates have been factored in for at least 21 procedures and diagnoses such as: heart bypass surgery, pacemaker, defibrillator, heart attack, heart failure, valve replacement, back & neck surgery, carotid surgery, COPD, gall bladder, hip fracture, hip replacement, knee replacement, prostate surgery, TURP, pneumonia, stroke, bowel obstruction, GI bleed, pancreatitis, diabetes hospitalization, pulmonary embolism & sepsis. Hospitals listed by state
Overall composite home health ratings of quality and patient satisfaction based on a summary of 14 or more measures of care in 2015-2016. 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
Overall hospital rankings based on a summary of readmissions, mortality, AMI (heart attack), heart failure, stroke, blood clot, surgical infection prevention rankings, plus patient opinions and more. Health Insight, a project of Oregon, Utah, New Mexico and Nevada, developed a helpful composite ranking for nearly every hospital in the nation, using at least 30 national CMS measures and satisfaction ratings from inpatients. Results shown by state. Easier to use than the federal HospitalCompare website, but less detail. Dates are a little unclear
Overall composite nursing home quality ratings based on a summary of 15 quality measures on over 15,000 nursing homes in 2017 (page footnote says 2016). 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.
This tool 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. 2016-2017 data
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, including those who have signed the Quality Partners Pledge
Compare up to 3 hospices at a time at Hospice Compare. Site currently reports 7 quality measures related to patient preferences and quality of care in managing pain and treating symptoms, 2018 data. Consumer 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 85% 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 the average price for 28 types of hospital outpatient charges to Medicare patients. Includes average charge for 24 million Hospital Clinic Visits ($199) and average discount of 52%; Level 1 through Level 3 examinations (average charge from $109 to $1334, with discounts from 53% to 72%.) All other procedures (APCs) such as Endoscopy, nerve injections, ultrasound, EKG, MRI, Pulmonary Tests, Cardiac Imaging, Sleep Studies, Excision/Biopsy, Debridement, Noninvasive physiologic studies, eye tests, or electronic analysis of devices, have Medicare discounts from 63% to 90% off the charges. Example: Medicare paid $277 (including patient portion) on an average charge of $2867 for an MRI in CY 2015. Each state’s average is also shown. In a separate Excel file, find the average charge by hospital (excluding Critical Access Hospitals). Difficult to use, from CMS August 2017
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 13.2% for heart attack, 11.7% 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 24 for heart attack, 135 for heart failure and 23 for CABG. Results updated 2018, 2014-2017 data
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 15.7% for pneumonia. Of US hospitals measured and reported, vast majority were statistically no different than national average; 242 hospitals had worse survival rates. Find pneumonia mortality ratings under Complications and Deaths measures. Results use 2014-2017 data, updated 2018
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 14.3% for stroke, an improvement over last year’s report. Of US hospitals measured and reported, vast majority were statistically no different than national average; 70 hospitals had worse survival rates. Find stroke mortality ratings under Complications and Deaths measures. Results use 2014-2017 data, updated 2018
Federal government gives 1 to 5 stars and compares hospital ratings for heart attack (AMI), heart failure, pneumonia, COPD, stroke, hip & knee, preventing surgery infections, timeliness of Emergency (ER) dept., use of medical imaging in 2017 – 2018. 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 from 2017 – 2018. 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
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 8.3% for COPD. Of US hospitals measured and reported, vast majority were statistically no different than national average; 95 hospitals had worse survival rates. Find COPD mortality ratings under Complications and Deaths. Results use 2014-2017 data, updated 2018 and each July
Compare hospitals in certain states on how well they prevent infections. Half the states (CA, CO, CT, DE, FL, IL, ME, MD, MA, MN, MO, NH, NJ, NM, NY, OH, OK, OR, PA, RI, SC, TN, VT, VA, WA) produce a report on healthcare infections. Consumers Union (the publisher of Consumer Reports), actively promotes public disclosure of hospital infection rates at SafePatientProject.org and tracks state laws on infection reporting. Time periods and reports vary.
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 2018 ratings are from Medicare patients, from 2014 to 2016. Click on More to see 3-year patient volume, and actual mortality or complication rates compared to predicted. Patient satisfaction ratings (2016-2017 data) are featured by HealthGrades. One hospital at time, unfortunately
Kaiser Family Foundation reports average health insurance premium cost of $6368 per year (about $531 per month) from 2017 for a single person’s policy. Only five states averaged less than $6000 for a year for one person: AR, GA, ID, MS and NV. Employee contributions were the lowest in Hawaii at about $56 per month, with employer contributions picking up the rest of the cost. Employees paid on average $146 per month in Massachusetts, the highest contribution. Average single employee contribution in US was about $118 per mo. ($1415 per year) or 22% of the total premium; employers paid 78% of single coverage premiums on average. Compare how much a month insurance costs in each state. Benefit coverage varies by state and policy.
J.D. Power and Associates selected Kaiser Permanente as its top Medicare Advantage plan for 2018, the only plan to get a 5-star rating. Highmark came in second with 4 stars. Other plans compared (in order of preference) were Cigna HealthSpring, Humana, UnitedHealthcare, BlueCross BlueShield of Michigan, Aetna, Health Net/Allwell, Anthem and WellCare. Ratings factors were Overall member satisfaction, Choice of providers, Communication, Claims processing, Customer service, Costs, Coverage and benefits. Unclear how and when the study was done.
Site shows race/ethnicity comparisons for health insurance coverage and uninsured. Shows 2016 data, the third year of coverage through the Health Exchanges. Highest uninsured rates were in TX (17%); Alaska and Florida tied for second worst at 15% uninsured; AZ, Georgia and Mississippi followed with 14% uninsured
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 volume standards of 50 High-Risk Delivery-Neonatal ICU patients per year. Info on infection rates and early elective cesarean deliveries also reported. Many hospitals participate; easy to compare. Updated for 2017, but period covered is unclear. Leapfrog was a pioneer in getting ratings in the public eye
Leapfrog named 109 hospitals to its 2017 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
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 and the five 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 providers
This fraud prevention site is 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. Thousands of listings
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
A difficult to use Excel file of amounts paid to hospitals by Medicare, on average for FY 2015. 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.
See this file for 25 procedure payments by Medicare and what they considered the Allowed Amount. This file 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. This is the best of what’s out there nationally, with state average charges. 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. 2018 premiums available for open enrollment ending Dec. 7, 2017
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. Two private commercial plans received the highest possible 5-point rating: Group Health Cooperative of South Central Wisconsin, and Kaiser Foundation Mid-Atlantic States. 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 2019
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 2018 data. If you cannot find the nursing home you’re interested in, the facility might not accept Medicare and Medicaid patients. 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
MemberoftheFamily.net provides information about 16,000 Medicare and Medicaid-certified nursing homes in the United States, including reports based on recent government surveys. This watch list tends to identify a lot of nursing homes where quality of care concerns have been identified. Updated with 2017 reports
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 prevalence rates for adults from 2015 to 2017. Data shown in the maps were collected through the CDC’s Behavioral Risk Factor Surveillance System (BRFSS). Updated October 2018
Medicare reported its average allowed cost for established patients’ physician office visit in 2012: $69 for CPT code 99213, $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
Transplant survival rates on a regional basis (1-year, 3-year, 5-year) compared to national; kidney, pancreas, liver, heart, lung, intestine. Organ Procurement and Transplantation Network (OPTN) Updated 2018 with 2015 survival data (2017 volumes).
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.
Difficult file to use for 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 also 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. Terribly dated; last updated Sept. 2013
Difficult file for consumers to use unless familiar with Excel. Allowed amounts (rather than prices) in the Ambulatory Surgery file for 25 Common high volume outpatient surgical procedures in a Surgery Center, 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), correction of bunion, and more. Uses CPT codes, and all states are listed. Terribly dated; last updated Sept. 2013
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
5 hospital winners were selected for the QUEST® Award for High-value Healthcare. They achieved top performance in all seven of the areas measured: cost and efficiency, inpatient and outpatient evidence-based care, mortality, safety, patient experience and appropriate hospital use.
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, organized by region and area
The Commission on Accreditation of Rehabilitation Facilities 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 27 million people under age 65 and without health insurance are located, after the Exchange went into effect? Kaiser Family Foundation shows the number uninsured by state. Ten states make up 59% (over 16 million) of the US uninsured under 65: Texas, California, Florida, Georgia, New York, North Carolina, Illinois, Arizona, Virginia and New Jersey. KFF statehealthfacts.org updated 2017
Kaiser Family Foundation State Health Facts shows state by state map and table for percent of smokers who attempted to Quit Smoking. Overall 59% tried to quit, US-wide according to the most recent (2016) data. What is happening in your state?
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 Jan. 2018.
Compare 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; data have not been updated
Waiting list numbers of people waiting for a transplant: Kidney, pancreas, liver, intestine, heart, lung transplants. In January 2018, about 115,000 people were waiting for a kidney. Survival rates shown on a regional level
Level I, II and III Trauma Centers are listed here, by state (and other international locations), at the American College of Surgeons’ 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.
Mayo Clinic (Rochester, MN), Cleveland Clinic and Johns Hopkins (Baltimore) top the list of 20 US hospitals identified (from 4656 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. 2018-2019 ratings use Medicare data from 2014-2016
Top of the Cardiac specialty list: 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 2013 to 2015. Hospitals ranked higher if they participated in public transparency reporting by the medical professional societies. Minimum volume of 1382 cases over 3 years, of which 500 needed to be surgical
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 urology. Honor roll of 10 hospitals is led by Boston Children’s, Cincinnati Children’s, and Children’s Hospital of Philadelphia. List called Best Children’s Hospitals updated June 2018. Detailed hospital scores for individual measures such as survival, are in the Methodology report
US News & World Report again named University of Texas MD Anderson (Houston, TX) and Memorial Sloan-Kettering (New York) as its 2018 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 cases was 195 (over 3 years), of which 33 needed to be surgical cases.
Sixty six (66) Medicare Advantage health insurance plans are shown by state if they have achieved 4.5 of 5 stars by Medicare. Advantage plans combine Part A and Part B
Just 13 plans earned 4.5 or 5 stars from Medicare for Part D (drug) coverage. Twelve are some form of Blue Cross plan, except for WPS Health Insurance in Wisconsin
Detailed scorecard for all of the Veterans Health Administration hospitals using 2012 data. Ratings for heart care, diabetes, pneumonia, health screening, surgery and other infections, quality of care, patient satisfaction, waiting times, continuity of care, accreditation and patient safety. Report is not user friendly since consumers will have to dive into the 35 pages of data tables. (Only page 22 in the Report Card shows comparisons). But if you really want to compare VA hospitals, the information is there. December 2013
The Veterans Affairs Office of Inspector General (OIG) makes its VA Medical Center oversight reports available online. Titles include Combined Assessment Program or Community Based Outpatient Clinic Reviews; Audits; or Healthcare Inspections. Listed by date; use filters on right within each category to select location. Topics include quality ratings and patient safety, consumer satisfaction & experience of care, nursing home contracts, screening and/or treatment times, volumes and more. Updated 2018
The Department of Veterans Affairs provides a convenient search tool to find medical facilities such as hospitals and clinics. Facilities in the US, American Samoa, Philippine Islands, Guam, Puerto Rico and Virgin Islands
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 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, HI, MN, MT, PA, TN, WI and WY, many drugs will carry higher prices, or may not be available. Prices apply to Sam’s Club pharmacies also
List names top 100 hospitals in categories according to size and teaching status using Medicare data primarily from 2015 and 2016, other publicly reported patient satisfaction scores and results such as mortality rates, readmissions, ER times and spending at HospitalCompare. While no data are shown for individual hospital performance, Truven 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. Released March 2018
Watson Health (formerly Truven Health Analytics) 2018 selection of 50 hospitals with significant heart care programs 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 2015-2016. It examined both clinical outcomes (e.g. survival or mortality, complications, readmissions) and efficiency measures. Released November 2017