patient health care advocates

3 Ways Patient Health Care Advocates Can Help to Navigate the Health Care System

There’s good news and bad news when it comes to navigating the health care system in America. The good news is that we live in a country with the most technologically advanced medical care in the world. The bad news is, that for our citizens, determining how to best utilize our health care system, in a free market economy, can be one of the most perplexing of challenges we face. Patient health care advocates can be priceless assets assisting patients navigating the health care system.

 

Imagine suddenly finding yourself in a metropolitan hospital emergency room, the survivor of a major motor vehicle accident. Alternatively, perhaps you’re the matriarch of the average American family unexpectedly diagnosed with breast cancer.

As if confronting such life changing medical scenarios isn’t enough, you’re also charged with feeling your way through the maze of conundrums that arise when toiling arduously within the complex health care system existing in the United States of America today. It’s a case of shock upon shock⎯the ultimate kicking a fellow when he’s down! Maneuvering through health care in this country has become as complicated as  the pathology of the most complex of diseases.

Patient Health Care Advocates and Their Vital Roles in America

Patients facing major trauma or disease need all of their available strength and fortitude to meet the associated demands of healing and restoration to optimal health. The less they have to worry about the hows, whys, and wheres of obtaining and managing their healthcare, the better.

Visiting and paying for medical care becomes increasingly more complex, it’s common for individuals to designate someone to the role of healthcare advocate (HCA). The HCAs or Patient Health Care Advocates, as the term implies are individuals acting as advocates for someone entering the health care system; they may or may not have power of attorney. It may be a responsible family member, relative, or friend that is able to help those in need as they maneuver their way through an otherwise confusing and complex system.

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Sometimes the Advocate may be a coworker from the patient’s employer and as such, that person may share the patient’s same insurance or health care coverage thereby being familiar with the necessary details surrounding access to care or medical reimbursement.

The Patient Health Care Advocates also serve to help with asking questions and cataloging information or taking notes when  patients are meeting with doctors or other health care professionals. Knowledge is power and the quest for more education never ends when it comes to facing medical challenges.

There is a helpful acronym for remembering three main areas where a designated HCA can be helpful: D.O.C.

3 Ways Patient Health Care Advocates Can Help

The first area involves “Determining” the best health care plan to cover payment for medical care and procedures. In the United States there are numerous possibilities when determining the best coverage plan. For some patients the decision may already be made such as with an employer provided health care plan. Still, an individual may need to choose between an HMO, Health Maintenance Organization or PPO, Preferred Provider Organization. HMOs have less flexibility regarding doctor choices whereas PPOs offer more options in determining providers of care.

In some cases the traditional fee-for-service health insurance plan may be the best option although it’s also the most expensive. Alternatively patients may meet requirements for government programs including Medicare or Medicaid, both of which can confuse anyone. But with the guidance of Patient Health Care Advocates and numerous on line websites, understanding the benefits of these programs becomes a less daunting task.

Finally, under the current administration, patient’s options may be limited to the “Affordable Care Act” (Obamacare), particularly in the cases of some seniors, certain youngsters, and those with pre-existing conditions.

One of the best resources for understanding health care options in America is the Center for Healthcare Innovation at www.chisite.org.

Organizing” health histories is the second major area where Patient Health Care Advocates can be quite helpful. Particularly if an individual is medically incapacitated, having someone designated that has an understanding of a patient’s medical history is extremely important. This would include past medical conditions, prior surgeries, current medications, allergies to medications, and medical risk factors like smoking or alcohol consumption. It’s a good idea to have this information typed onto a document that can be carried in a purse or wallet making it readily available in urgent or emergency situations.

The third major area where Patient Health Care Advocates can be most beneficial is with “Choosing” a doctor or healthcare provider. There are many reasons behind selecting the right clinician for the role of partnering with you in the challenge of guiding your restoration to optimal health.

Achieving wellness of body, mind, and, spirit is a team sport where you are the athlete, the physician is coach, and the paramedical professionals are your teammates who champion your recovery.

First and foremost when determining the right doctor, a patient needs to feel confident that he or she can work together with the physician. Assuming patient and clinician are mutually compatible and constructive, it’s sensible to find a doctor with specialized training in the appropriate or pertinent branch of medicine.

Also, contrary to the beliefs of many, some of the most qualified doctors are in large metropolitan hospitals as opposed to community based private institutions. Larger inner city hospitals are usually affiliated with major universities, having their fingers on the pulse of the most current practices and standards of care. Teaching hospitals have direct access to medical schools and top researchers in their fields thereby, as institutions, readily in practice with the latest technology and data bases.

Suddenly faced with a major life changing trauma or disease can be among the most stressful occurrences one ever faces. Having Patient Health Care Advocates to help with guiding one through the challenging obstacles within our health care system can be a vitally valuable asset in the 3 major areas of D.O.C. in addition to many others. One of the best available resources can be found through the Patient Advocate Foundatio

Have you or a family member utilized the services of a Patient Healthcare Advocate?

Comment how you or someone you know has benefited from having a Patient Healthcare Advocate.

Photo credit Wikimedia

  • Thanks for this advice, Mark. So many people feel helpless when confronted by a behemoth health care system.

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