Choosing Your Advocate: Hospital-Employed vs. Independent Support
The healthcare system is complex and can be overwhelming. These challenges are exacerbated when a loved one is diagnosed with chronic illness. A patient advocate can be crucial in navigating the complexities of healthcare. This holds true even when receiving treatment from well-regarded facilities, such as NorthShore Kellogg Cancer Center or City of Hope Cancer Center North Shore.
Harris Poll data from 2023 revealed that only 27% of Americans feel the healthcare system meets their needs. And in a 2022 survey, 92% of healthcare providers stated that the presence of an advocate has a positive effect on patients. However, according to Johns Hopkins Medicine, only 70% of patients designate a health advocate.
This article explores the importance of patient advocacy, the key differences between types of advocates, and common questions about working with an independent patient advocate.
The Importance of Patient Advocacy
Patient advocates work to ensure that individuals receive the best possible care, tailored to their specific needs. Advocates are a bridge between patients, families, and the healthcare system, helping to clarify complex medical information, communicate effectively with healthcare providers, and navigate insurance coverage.
Patients often find themselves feeling lost or overwhelmed. Patient advocates provide support and guidance during challenging times. For example, a private patient advocate can identify errors in coverage or misinterpretations by medical staff, ultimately saving patients and their families significant financial burdens, and ensuring timely access to necessary medical treatment. Whether care is received at home, or involves coordinating with facilities such as Vi at the Glen or North Shore Place, a patient advocate ensures continuity of care
Effective advocacy promotes not only better health outcomes, but also a sense of empowerment for patients and their families. It facilitates informed decision-making and encourages patients to take an active role in their medical care.
Key Differences Between Private and Hospital Advocates
Many hospitals and insurers have advocates on staff. These individuals may also be referred to as “patient navigators.” While both hospital and private advocates aim to support patients and their families, their roles and capacities differ significantly.
Employment and Focus: Hospital advocates are employees of the healthcare institution and help navigate its specific systems. As Greater National Advocates notes, they typically "practice more like customer service representatives" than a personal advocate. They may assist with logistical issues, such as billing inquiries or directing patients to appropriate departments or social workers. However, they often have limited authority and resources.
Specialized Background: Many hospital advocates lack extensive medical or billing training, which can hinder their effectiveness in navigating complex cases. In contrast, private patient advocates often possess specialized knowledge and experience in healthcare systems, insurance policies, and clinical processes, enabling them to provide more comprehensive support.
Caseload and Attention: Hospital patient advocates often handle heavy caseloads, which limits the time they can devote to individual patients. Private advocates work one-on-one with patients and their families, enabling them to focus on specific needs and concerns.
Conflict of Interest: Hospital-employed patient advocates may face conflicts of interest as they work within the healthcare system. As the Alliance of Professional Health Advocates notes, "just as providers have an allegiance to their employer, so do hospital and insurance company advocates." Independent advocates, however, are dedicated solely to the patient's interests, providing objective guidance and support.
Advantages of Hiring an Independent Patient Advocate
Engaging an independent patient advocate presents numerous advantages, particularly in complex or high-stress medical situations.
Personalized Support: A private patient advocate works for you or your loved one. They offer tailored assistance, focusing on the unique needs and preferences of the patient and their family. This personalized attention can lead to better communication and understanding of the patient's condition and treatment options. The Alliance of Professional Health Advocates compares private advocates to private education: the patient or student is making an investment in a higher level of dedicated attention and service.
Expertise and Experience: Many independent patient advocates have backgrounds in healthcare, nursing, or medical billing. Their expertise allows them to navigate the complexities of healthcare systems and insurance providers more effectively than a hospital advocate might.
Unbiased Representation: Because independent advocates are not affiliated with any healthcare institution, they can provide unbiased support and recommendations. This objectivity ensures that the patient's best interests are prioritized without any conflicts of interest.
Empowerment Through Education: Independent advocates empower patients and families by educating them about their rights, treatment options, and care processes. This knowledge equips patients to make informed decisions and advocate for themselves when necessary.
Enhanced Communication: An independent advocate can facilitate communication among various healthcare providers and across hospitals and systems, ensuring that the entire healthcare team is working towards the best possible outcomes for the patient. They can also help translate complex medical terminology into understandable language for patients and their families
Additional Services: Independent Patient Advocates provide crucial non-medical services that significantly ease the healthcare navigation process for patients and their caregivers. These advocates assist with logistical tasks like coordinating medical appointments, arranging transportation, and managing referrals. They can also play a crucial role in addressing financial and logistical challenges by helping patients understand insurance options, appeal denied benefits, resolve billing disputes, and qualify for financial assistance programs.
Is a Private Patient Advocate Worth the Cost?
For families in the North Shore facing chronic illness, private patient advocacy provides immense value. They save time, reduce stress, ensure unbiased guidance, coordinate complex care across top local providers like NorthShore and Northwestern Medicine, and can prevent costly errors, offering peace of mind.
Choosing the right advocate is a critical step in navigating complex health challenges. An independent advocate, solely dedicated to your family’s needs, offers unparalleled personalization, objective guidance, and expert navigation across the entire healthcare landscape. They don’t just provide support, they partner with you to ensure the highest quality of care. Schedule a consultation to discuss your family’s needs with Avoa Health.
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