This article marks the second in a four-part series cataloging Carle Hospital, and what it does, both good and bad, for the Champaign-Urbana community. Stay tuned to Smile Politely Opinion for the following parts. View part one here.
Carle is generally recognized as being a very good medical provider within a considerable distance from CU. However, many of my neighbors expressed dissatisfaction over certain issues shown below. Their comments, although anecdotal, include:
Lack of detail in billing statements – A good friend of mine was recently admitted to the ER after breaking her hip. The bill read: “Inpatient…….$58,202.36” That was it. A representative from Carle’s Financial Services Division informed me that patients had requested this abbreviated format. She assured me that Carle would provide detailed information upon request. Another neighbor reported “Regarding billing practices, I got a 75K bill when my mom had her hip fixed by them. The care was exemplary, the bill was head-scratching, and when I called them up they said “oh, just ignore that,” which filled me with … dread.”
Cell phone calls to physicians during examinations – This has happened to me several times, but only within the past couple years.
Inconclusive customer satisfaction surveys – No questions of primary interest to the patient. An example case in point: ” They give tons of questionnaires about the care, but have no place to voice complaints about how things are run.” This issue may be important because incomplete survey information could bias Carle’s overall ranking.
Facility fees – According to Carle’s service rep these have been charged since the combination of the hospital, clinic and Health Alliance. She said that these are “required by law” to offset infrastructure costs of the hospital and clinics.
Medicare readmission penalties – More than 100 Illinois hospitals face federal fines in the new fiscal year because too many of their patients returned to a hospital within 30 days of being treated. The penalties are aimed at making hospitals more involved with patients’ well-being after discharge. Carle readmitted 0.32% of its patients in 2015, up from 0.20% in 2013.
Limited availability of PrImary Care Physicians (PCPs) – My wife has experienced this firsthand. When calling Carle to schedule an annual physical she was told with no notice or explanation that her PCP was no longer employed there. It took her quite some time to locate a doctor, in Mahomet. Similarly, my sister is new in town and was searching for a woman physician. She finally found one within the Carle system in Monticello. Also, doctors must sign a “non-compete” clause when they join the clinic that prevents them from practicing medicine for a certain period of time within a certain distance from C-U. This serves to reduce the number of doctors for all. From many accounts, this is a serious problem.
Coordination of computer systems – “I was calling on the phone to make an appointment…the woman asked for the name of my primary care physician. I told her and then got an “um” response to my reply. They had no record of my doctor of 30 years retiring from Carle over a year ago and of me choosing a new doctor, who I’d seen twice by the time I was on that call.
You’d think that their multi-million dollar computer system would get updated once in a while when a patient’s details change.”
CARLE OR PRESENCE?
Consumer Reports allows a direct comparison between the two hospitals in town, Carle and Presence Covenant, rating them much as they evaluate other goods and services. The categories considered are patient outcomes (infections), other patient outcomes (survival rates), patient experience and hospital practices. Scoring is done on a five-point scale, with 5 being the best and 1 the worst.
The numbers shown below are composite scores for all the sub-elements contained in the four categories listed above:
A final indication of hospital effectiveness is indicated by its Consumer Reports safety score – a composite of five key measures of patient safety: readmissions, complications, communication, overuse of CT scans, and infections. The higher the CR the better. Here Carle received a 46/100 while Presence rated 55/100.
For primary care, emergencies and treatment in some specialties, Carle may be the preferred option. For more serious medical conditions one may choose another health care provider. In fact, I personally know of several cases where Carle has referred a patient to another hospital on its own.
Fortunately, you have options.