Choosing a Good Hospital

Choosing a good hospital is important

♦ Which hospital is the best for your needs?

Research shows that some hospitals do a better job taking care of patients with certain conditions than other hospitals.

• When you have a life-threatening emergency, always go to the nearest hospital.

However, if you're planning to have surgery, or you have a condition like heart disease and know you may need hospital care in the future, you need to learn about your choices.

Understanding your choices will help you make a more informed decision.

What to consider before deciding

Do you want a hospital near family members or friends?

Does the hospital have convenient visiting hours and other rules that are important to you?

• For example, can a relative or someone helping with your care stay overnight in the room with you?

• Does the hospital accept your insurance plan? More importantly, is it in your plan's network?

• What is the quality of care you can expect to receive?

• Will the hospital make you sick?

• Choosing a hospital shouldn't be a last-minute decision.

Knowing which hospitals in your area have the best track record treating your condition could mean the difference between a safe, speedy recovery and one with complications.

Knowing which hospitals your insurance covers is critical to avoiding severe financial hardship.

How to choose a good hospital

When it comes to choosing a hospital, most people depend on their doctor.

Their doctor will direct them to the facility where he or she has privileges. That means they're permitted to perform procedures at that hospital.

Your doctor may have privileges at more than one facility. If one is more convenient for you or has a better track record, let your doctor know.

• Don't be afraid to ask your doctor which hospitals have the best experience with your condition. Or whether you should consider a specialty hospital, teaching hospital, community hospital, or one that does research or has clinical trials related to your condition.

• Ask friends and family about their experiences and recommendations. They may not have direct experience, but they may know the reputation of the hospital you're considering.

♦ A number of websites have nurses and doctors write articles telling you to ask the hospital how they will treat you and your condition. We haven't found this approach to be useful.

Most of the time we've been referred to someone with the title Patient Advocate.

The title is a bit misleading, since they work for, and advocate for, the hospital.

• Don't expect to hear about any negative experiences. You need to do some serious digging elsewhere for that.

There are resources to help judge the quality of hospital care, especially for common procedures such as cardiac bypass surgery. Many are online and let you search for a particular hospital.

Some states have laws that require hospitals to report data about the quality and cost of their care and post the data online.

• Information reported online is often incomplete and may not address your condition. Still, you can usually get a general idea of how well a hospital treats its patients.

• Don't confuse outpatient surgery centers with hospitals.

Some are operated by hospitals or even operate inside the hospital itself. Most are independent of hospitals.

• Most outpatient surgery centers aren't required to report infections or other complications the way hospitals are.

Compare hospitals

This should be your first step in your online search.

The U.S. Centers for Medicare & Medicaid Services (CMS) collects most of the data. Hospitals that accept Medicare are required to report.

CMS shares this data, so some online sites repackage it into a more attractive format. Some even go so far as to try to sell reports based on it.

The data is readily available and free at the website called Care Compare.

Here you can search by zip code or facility name. View the report for the hospital you're interested in.

The hospital will have a star rating for overall quality. The more stars the better.

There are several tabs to click on and see data collected for various outcomes. Patient experiences is one, and of course complications and deaths is an important one to review.

Care Compare now shows data on hospital infections, complications, deaths, readmissions and patient experiences for most hospitals. It's not perfect, but it's a lot more than patients used to have.

Below is a screenshot of a major hospital in Atlanta, Georgia, taken in [November, 2026]. Star ratings are updated each year.

LeapFrog

Another nice website with a cute name.

Unlike the CMS site, the Leapfrog data can be a bit limiting because it's voluntary.

Many hospitals aren't willing to answer all the survey questions Leapfrog poses to them. The question becomes: why?

The Leapfrog Group is a consortium of corporations and public agencies that purchase health care for their employees.

They survey thousands of hospitals across the country on quality and safety practices, including ICU staffing and computerized records.

You can search its online database to see how your local hospitals performed.

Go to Leapfrog's website and click on the Search hospital and surgery center ratings button. Searching by zip code is the easiest.

The results are presented as a long list of events covering patient care and safety.

• You may want to select the option to show hospitals that didn't respond to Leapfrog's request for patient safety and quality data.

The main web page also has a separate link at the bottom of the page to the Leapfrog Hospital Safety Grade.

Here you can see most of the same information, but in a more colorful format. And also a bit more disturbing.

♦ Leapfrog updates its Hospital Safety Grades twice a year, in the spring and fall. Check again before a planned stay.

Others - less useful

Joint Commission has a searchable database. Joint Commission is a nonprofit group that inspects and accredits many hospitals and other organizations.

They issue what they call a "Gold Seal." It's not clear how valuable this is to actual consumers.

You can search the site by zip code and download a report on a hospital in your area. Their reports read more like an advertisement of services and less like a report on outcomes.

U.S. News & World Report publishes a well-known "Best Hospitals" list. It's free and broken down by specialty. Keep in mind part of the ranking is based on reputation among doctors, not just patient outcomes.

Consumers' Checkbook has a website, but it isn't free.

Most people aren't familiar with Consumers' Checkbook. It's a nonprofit that has been around since 1974.

They charge a small annual fee to search their data. They say it's because they don't accept advertising or kickbacks for referrals.

They have partnered with a few Marketplace sites to provide insurance plan comparison tools.

They have a scattering of information on a variety of health care providers, plus dentists. They don't cover all of the U.S., but they may have some information for your area.

Their site is Checkbook.org.

Review Sites

There are a number of review sites where people leave comments about their experiences.

Most of the sites focus on doctors, but some have reviews of hospitals.

Some present data on hospitals that's mainly pulled from CMS records.

We devoted a separate page to them: Popular Doctor Review Sites.

Check prices

• Look up prices before planned care. Hospitals are required to post their prices online. Search the hospital's website for "price transparency" or "price estimator." The numbers can be confusing, but it gives you a starting point to compare.

Will my insurance pay?

When we have a serious illness or complicated procedure, everyone wants to receive the best treatment. But the best usually comes with a steep price.

That price gets blown out of proportion if your insurance doesn't cover the hospital you use.

♦ It's critical to understand which hospitals in your area are covered by your insurance.

If you have an HMO or EPO plan, the number of hospitals can be severely restricted. If you're not familiar with HMO plans, you can read more about them at Types of Health Insurance.

Emergencies

♦ In a real emergency, go to the nearest hospital, in network or not. Federal law protects you:

• Your insurer has to decide whether it was an emergency based on your symptoms, not your final diagnosis. Chest pain that turns out to be heartburn still counts.

• Your plan can't require approval before emergency care.

• Since 2022, the No Surprises Act says an out-of-network hospital can't charge you more than your in-network costs for emergency care.

For planned care, it's a different story. If you choose an out-of-network hospital for a scheduled surgery, your HMO or EPO plan likely won't pay, and a PPO will make you pay more.

Planned care

• PPO and POS plans have more options. These plans have network hospitals, but they also let you use hospitals that are out of network.

PPO plans cost more than HMO plans, but they provide greater flexibility.

Keep in mind, if you use an out-of-network hospital, PPO plans shift more of the cost to you in the form of higher copays, coinsurance and out-of-pocket maximums.

♦ Traveling out of your local area might be the best choice in some cases.

Maybe you need an unusual or difficult procedure or operation that your local doctors can't perform. Or you want to enroll in a clinical trial in another state.

Your insurer might insist you use local hospitals and refuse to approve going outside your network's area.

• If you run into this situation, you may have the option once a year to switch insurance plans.

♦ People with individual health insurance and Medicare have an open enrollment period each fall.

Most employer-sponsored health coverage has an open enrollment period too, but the choice of plans is usually very limited.

If you're near the end of the year and can wait, switching to a more flexible plan may be a speedier option than getting into a long fight with your insurance company.

Is my local hospital in network?

Call your insurance company and ask. The number to call is on the back of your insurance card.

Your insurer will tell you which hospitals are in your network. You can find this information on your plan's website, but website information is often out of date.

• Providers come and go from plans all the time.

♦ It's always good practice to call the hospital you're considering and confirm they're in fact in your plan's network. When you ask the hospital staff if they accept your insurance, be sure to ask about your particular plan.

Your plan's ID or group number is on your insurance card. Many larger insurance companies, like Blue Cross Blue Shield, have a variety of plans.

The hospital may accept most but not all. Always ask. And always write down the name of the person you spoke to.

♦ If your insurer's directory says a provider is in network and it turns out to be wrong, federal law says you generally should only pay in-network costs. Take a screenshot of the directory listing, and write down who you talked to and when. That's your proof.

Approval / Authorization

Do you need permission from your health plan (like a preauthorization or a referral) before you're admitted for hospital care? In most cases, your doctor will make this request.

If you're going to the hospital for testing, the hospital will receive your doctor's order and will usually request authorization. They want to know how much to collect when you arrive.

If you're going to the hospital's outpatient department, most procedures will require preauthorization. This is usually started by the doctor performing the procedure.

♦ Never assume someone else did this automatically. Ask your doctor and ask your insurance company. Ask before you go.

Conclusion

First decide what would be best for you. Do a little research until you reach your comfort level.

And then, before deciding… visit.

• Visit the hospital and observe how it looks and smells. Is it well maintained and clean?

Talk to some of the staff. Ask yourself: do the people working there seem friendly and relaxed?

Is this a facility with a healthy work environment?

If it is, your chances of having a better experience and a successful health outcome just went up.