Health Care:

(Money Magazine) -- There's a movement afoot to make you directly pay more of the bill for your health care. The theory is that this will make you more choosy and that you'll put more effort into comparing costs and researching doctors and hospitals.

But for that to happen, of course, you'll need good information to work with. It takes five minutes of Web surfing to compare prices and features and to check out customer reviews on, say, a digital camera.

But for health care? "We just haven't evolved to that level," says Jean Chenoweth, a senior vice president at Thomson Healthcare, a division of the giant information services company.

Take charge of your health care

The picture is getting a bit clearer though. The government has pushed to create better data for comparing hospitals. Companies are building online tools to help you sort through what's out there; some of the best sites are run by insurers themselves.

You can find out about a doctor's experience and a hospital's success rates, and even a bit about the murkiest part of health care: what it costs.

Get to know your doctor

Before you go online, you'll probably want to start the search for a doctor the way you always have: with a personal recommendation. When you're looking for a pediatrician, for example, a lot of what you really want to know - like whether he answers phone calls at 2 a.m.- are things your friends know more about than any website.

And if you have a family doctor you trust, her word should count for a lot when you ask about a specialist. But once you have some recommendations, use the Web to double-check that advice and to narrow down your choices. So where do you start?

Board certified is best. A doctor must pass written and oral exams in her specialty and meet education requirements to call herself board certified. Search for your recommended doctors at abms.org, which keeps the most up-to-date list.

Make sure she's had practice. Frequent practice begets quality care, making it a good measure of doctor quality, says Janet Corrigan of the National Quality Forum, a nonprofit that helps set health-care quality standards. Run your list through Vitals.com, which for many states can show how many times a doctor has performed certain procedures in a year. If the information isn't there for your procedure, give the doctor's office a call to ask. You don't want a doc who's getting her feet wet at your expense. Less important: where the doctor went to medical school. Experience beats prestige.

Check for evidence of screwups.Vitals.com will also show whether doctors have a history of sanctions or malpractice claims. Sanctions are a real red flag, but you should keep malpractice claims in context. Some kinds of specialists are more apt to be sued than others, and the number of claims can also vary by region. So compare your doc's stats with those of a few alternatives in your area.

Know the price (as best you can). There's no such thing as a manufacturer's suggested retail price in medicine, and not all doctors or even insurers are eager to talk about costs. But if you're paying co-insurance or have a high deductible, it's well worth your time to call your doc and your insurer to get at least a ballpark figure.

And a few big health plans, including Aetna, have launched Web tools that let participants look up the rates they've negotiated with different doctors for office visits and common procedures. Other insurers' websites can at least tell you what the average cost in your area will be. If your insurer doesn't have this, you can buy a medical-cost report from HealthGrades.com for $8.

The right hospital

Performance information for doctors is still pretty thin, but there's more for hospitals. Your health plan's website might be your first and only stop for answers to many questions because it is able to combine government and other data with its own private files. Here's what to look for.

Just like doctors, hospitals get better with experience. To find out how many times a hospital has performed a procedure, search your insurer's online tool for your illness and narrow the list to those that have seen the most cases. You can find similar data at revolutionhealth.com.

Does the hospital have high standards? The National Quality Forum has teams of health experts who determine which practices are most likely to bring a good outcome for common procedures. If you're having any kind of surgery, for example, getting a dose of antibiotics before incision will greatly reduce the chances of infection. Hospitals report how often they follow those procedures. If your insurer doesn't track this, look up the hospital at hospitalcompare.hhs.gov. The tool will tell you not only the performance of hospitals in the area but how the top U.S. hospitals performed. It might not be reasonable to expect your target hospital to hit the Top Hospitals mark for every measure, but it should beat area averages.

You can also look up your hospital at leapfroggroup.org/cp to see whether it has proper staffing and equipment. (Note that some top hospitals don't participate in its surveys.)

See how well the patients fare. Your insurer might also track hospitals' mortality and complication rates on your procedure. These numbers are generally adjusted for the condition of the patient, so that a hospital isn't penalized for taking on tougher cases. Make sure your hospital's rates aren't worse than the average of all hospitals.

If your insurer's site doesn't carry the mortality data, you can turn to HealthGrades.com, which awards hospitals ratings for various procedures. These will show you the survival rates for patients while they are in the hospital and for up to six months after they've been discharged. Look for three stars or better.

Brace yourself for the big bill. As with doctors, hospital costs aren't easy to find. If you can, start the conversation with your insurer well before you go under the knife. Your plan's website may show you the average cost of a particular surgery in your region - a few have price ranges for specific hospitals - or you can buy a medical-cost report similar to the one you purchased about doctors from HealthGrades.com for $8.

   Need to know Terms:

  High-deductible health plan. An insurance policy that forces you to spend a large amount of money(typically from about 1,000$ to 10,000) before coverage kicks in. Some plans will fully cover some preventive care or drugs regardless of the deductible. In many cases high-deductible plans are linked to tax-free vehicles such as health savings account and health reimbursement arrangments.

   Health Saving Account or HSA. If you have a high-deductible plan that meets certain federal requirements, you can open an HSA to help pay your bills. You and your employer can contribute. As with an FSA, Federal Spending Account( Which is When a person, Every year is able to estimate your expected out-of-pocket health expenses and have your employer take that money out of your pay check and put it into an FSA before you pay taxes on it. You can spend it on co-pays, uncovered medical bills and maybe over-the-counter drugs. But if you don't spend what you set aside in certain period, you LOse it.) the money you put in is not taxed. And it isn't taxed when you spend it on qualifying health expenses either. But in HSA, the money is yours to keep until you need it. After you hit 65, there's no penalty for spending it on m=nonmedical expenses; you just have to pay the taxes. 

  Health Reimbursement arrangement, or HRA. Similar to an HSA, but only your employer contributes and it isn't yours to keep if you don't spend it.         

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        Web Site: http://money.cnn.com/2008/03/24/pf/healthcare_websites.moneymag/index.htm?postversion=2008032609

       Author: Joe Light (Money Mag. Staff Reporter)

  Title: Click Here for the Best Health Care

  First Published: March 25, 2008 4.21 A.M. EDT

  Date found info: April 15, 2008