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Health Insurance - Quick Checks for a Quality
Health Plan
Introduction
Research shows that Americans want and value quality health care.
The problem is that the quality of health care services varies in
our country—a lot. For example, some health plans and doctors
simply do a better job than others of helping you stay healthy and
getting you better if you are ill.
Fortunately, health care quality can be measured, and it can be
improved. You can find out how in a new guide developed by the Agency
for Healthcare Research and Quality (AHRQ) of the Department of
Health and Human Services (HHS). "Your Guide to Choosing Quality
Health Care" describes quality measures including consumer
ratings, clinical performance measures, and accreditation—what
they are, where to find them, and how to use them.
The guide provides other information, such as the following "Quick
Checks for Quality," that summarize the major ways you can
check for quality health care.
Quick Checks for Quality
Look for a plan that:
- Has been rated highly by its members on the things that are
important to you.
- Does a good job of helping people stay well and get better.
- Is accredited, if that is important to you.
- Has the doctors and hospitals you want or need.
- Provides the benefits you need.
- Provides services where and when you need them.
- Meets your budget.
Look for a doctor who:
- Is rated to give quality care.
- Has the training and background that meet your needs.
- Takes steps to prevent illness' for example, talks to you about
quitting smoking.
- Has privileges at the hospital of your choice.
- Is part of your health plan, unless you can you afford to pay
extra.
- Encourages you to ask questions.
- Listens to you.
- Explains things clearly.
- Treats you with respect.
When choosing a treatment, make sure you understand:
- What your diagnosis is.
- Whether treatment is really needed at this time.
- What your treatment options are.
- Whether the treatment options are based on the latest scientific
evidence.
- The benefits and risks of each treatment.
- The cost of each treatment.
Look for a hospital that:
- Is accredited by the Joint Commission on Accreditation of Healthcare
Organizations.
- Is rated highly by State or consumer or other groups.
- Is one where your doctor has privileges, if that is important
to you.
- Is covered by your health plan.
- Has experience with your condition.
- Has had success with your condition.
- Checks and works to improve its own quality of care.
Look for long-term care that:
- Has been found by State agencies, accreditors, or others to
provide quality care.
- Has the services you need.
- Has staff that meet your needs.
- Meets your budget.
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