Virginia Health Information Exchange – Consumer Healthcare Information

Virginia Health Information (http://www.vhi.org/) is not just a term that describes some of the advice and guidance we provide to consumers about their medical coverage. It's also a specific website that helps state residents with a plethora of free references, tools, hospital and physician finders, and comprehensive consumer guides. VHI partners with various private organizations and public entities to utilize health data to improve conditions and treatment in the Commonwealth.

Comprehensive data and information is provided regarding hospitals, nursing and long-term care facilities, HMOs, assisted living and continuing care facilities, physicians, and home care providers. Consumer satisfaction with medical facilities and quality of treatment is also reviewed. Transparency in published reports is always important, and updates are regularly performed. Comparison of healthcare providers and publishing quality indicators help carriers and consumers.

 

Virginia Health Insurance Coverage is available. Affordable medical coverage rates through the Marketplace can be found by providing your zip code at the top of this page. We search and compare the top-rated companies so you can get quality coverage. You may also qualify for a federal subsidy for all family members. Under the current Administration, tax credits are still available to help pay policy premiums, although the legal requirement to purchase coverage has been eliminated. Tax credits have increased in recent years due to changes in the US economy.
 

Listed below are several of the most helpful topics and a brief description of some of the provided services:

Health Care Prices

 

Cost Of Virginia Medical Services

 

Unless you have a copay on small and large procedures, you will typically have to meet a deductible. This means you will be paying the "negotiated price" agreed by the insurer and provider. Wouldn't it be nice to know in advance what dollar amounts are approved for this type of treatment? Listed below are results from the most recent research:
 

Ambulance Ride $550. CPT Codes A0425, A0427, and AO429.

Angioplasty $41,575 in hospital.

Ankle X-Ray  $147 in physician's office. $303 outpatient in hospital. CPT Code 73610.

Arthroscopic Knee Surgery $4,558 in ambulatory surgical center. $7,270 outpatient in hospital. CPT Code 29881.

Bone Density Scan $197 in physician's office. $612 outpatient in hospital. CPT Code 77080.

Breast Biopsy $1,820 in physician's office. $3,847 outpatient in hospital. CPT Codes 19103, 19081, 19083, and 19085.

Carpal Tunnel Surgery $3,254 in ambulatory surgical center. $5,245 outpatient in hospital. CPT Code 64721.

Cesarean Delivery $17,422 in hospital. CPT Code 45378.

Chest X-Ray $139 in physician's office. $248 outpatient in hospital.

Chiropractic Services $139 in physician's office.

Colonoscopy  $1,209 in physician's office. $2,828 outpatient in hospital. $1,759 in licensed ambulatory surgical center.

CT Scan (Abdomen)  $608 in physician's office. $1,335 outpatient in hospital. CPT Code 74160.

CT Scan (Head) $287 in physician's office. $975 outpatient in hospital. CPT Code 70450.

Cystoscopy  $387 in physician's office. $2,767 outpatient in hospital. CPT Code 52000.

Destruction Of Lesion $222 in physician's office. $596 outpatient in hospital. CPT Code 17000.

Digital Mammogram $332 in physician's office. $433 outpatient in hospital. CPT Code 77067.

ER Visit (Hospital outpatient) $1,091 outpatient in hospital. CPT Code 99283.

ER Visit -- Minor (Hospital outpatient) $531 outpatient in hospital. CPT Code 99281.

Emergency Helicopter Trip $19,466. CPT Code A0436 and A0431.

Endoscopy $1,211 in physician's office $2,866 outpatient in hospital. CPT Code 43235.

Foot X-Ray $142 in physician's office. $305 outpatient in hospital.CPT Code 73630.

Gallbladder Surgery $10,968 outpatient in hospital. CPT Code 47562.

Hernia $8,384 outpatient in hospital. CPT Code 49505.

Hip Replacement $34,350 in hospital.

Kidney Stone Removal $10,669 outpatient in hospital. CPT Code 50590.

Knee Replacement $34,926 inpatient in hospital. No other alternatives.

MRI On Back $617 in physician's office. $1,947 outpatient in hospital. CPT Code 72148.

MRI On Knee $605 in physician's office. $1,807 outpatient in hospital. CPT Code 73721.

Non-Maternity Ultrasound $319 in physician's office. $737 outpatient in hospital. CPT Codes 76700 and 76856.

Office Visit (Adult) $86 in physician's office. CPT Code 99213

Office Visit (Well Child) $126 in physician's office.

Physical Therapy $82 in physician's office. $188 outpatient in hospital. CPT Code 97110.

Rotator Cuff Surgery $10,660 Ambulatory Surgical Center. $16,253 outpatient in hospital. CPT Codes 23410, 23412, 23420, 23670, 24341, and 29827.

Shoulder Arthroscopy $9,726 Ambulatory Surgical Center. $16,755 outpatient in hospital. CPT Code 29826.

Tonsillectomy $3,676 Ambulatory Surgical Center. $6,338 outpatient in hospital. CPT Code 42820.

Ultrasound -- $235 in physician's office.  $714 outpatient in hospital. CPT Code 76805.

Vaginal Delivery $12,489 in hospital.

Well-Child Visit -- $126 in physician's office. CPT Codes 99391, 99392, and 99393.

 

The Most Expensive Drugs In Virginia (Commercial Usage)

 

HUMIRA PEN

STELARA

ENBREL SURECLICK

BIKTARVY

DUPIXENT

TRIKAFTA

TRULICITY

ELIQUIS

OTEZLA

XYREM

COSENTYX SENSOREADY PEN

SKYRIZI

JARDIANCE

OZEMPIC

GILENYA

TALTZ

GENVOYA

VICTOZA

AUBAGIO

JANUVIA

TRULICITY

TREMFYA

XELJANZ XR

 
Hospitals and medical centers located within the state, are divided into five Regions. VHI provides in depth information and comparisons for consumers. Some of these facilities include:
 

Southwest Region -- Bedford Memorial, Blue Ridge Surgery Center, Buchanon General, Carilion Franklin Memorial, Carilion Giles Community, Carilion Medical Center, Carilion New River Valley, Carilion Tazewell Community, Centra, Centra Health, Centra Speciality, Clinch Valley, Dickenson Community, DLP Twin County Regional Healthcare, Fairlawn Surgery Center, Johnstown Memorial, Lee County Community, LewisGale, New River Valley Surgical Center, Norton Community, Piedmont Day Surgery Center, Regional Surgical Services, Roanoke Valley, Russell County Medical Center, Smyth County Community, Sovah Health, Surgery Center Of Lynchburg, Surgery Center Of Central Virginia, Rehabilitation Hospital Of Southwest Virginia, Twin County Regional, Wellmont Lonesome, Wellmont Ridgeview, and Wythe County Community.

 

Northwest Region -- Augusta Health, Bath County Community, Carilion Stonewall Jackson, Charlottesville Surgical Center, Culpeper Surgery, Encompass Health, Fauquier, Fredericksburg Ambulatory Surgery Center, Martha Jefferson, Mary Washington, Monticello Community, Page Memorial, Sentara RMH, Spotsylvania Regional, Stafford, University Of Virginia Medical Center, UVA Culpeper, and Valley Health.

 

Central Region -- Bon Secours, Centra Southside, CJW Medical Center, Colonial Heights Surgery Center, Cumberland, Encompass Health Rehab, Henrico Doctor's Hospital, John Randolph Medical Center, MEDARVA Surgery Center, Parham Surgery Center, Popular Springs, Sentara Halifax, Sheltering Arms, Skin Surgery Center, Southside Regional, Stony Point Surgery Center, Urosurgical Center Of Richmond, VCU Community Memorial, Vibra Hospital, Virginia Beach Health Center, and Virginia Eye Institute.

 

East Region -- Advanced Vision Surgery Center, Bayview Medical Center, Bon Secours, Chesapeake Regional, Children's Hospital Of The King's Daughters, CHKD Health And Surgery Center, Coastal Virginia Rehab, Hampton Roads, Kempsville Center, Lake Taylor Transitional Care, Mary Immaculate Ambulatory Surgical Center, Riverside Walter Reed, Sentara Leigh, Sentara Careplex, Sentara Obici, Southampton Memorial, Virginia Beach Eye Center, and Virginia Surgery Center.

 

North Region -- Dominion, Encompass, Fairfax Surgical Center, HealthSouth Rehab, Inova Alexandria, Inova Fair Oaks, Inova Fairfax, Inova Mount Vernon, Inova Loudoun, Kaiser Permanante Tysons Corner, Lake Ridge Ambulatory Surgical Center, Northern Virginia Surgery Center, Norvant Health, Prince William Ambulatory Surgical Center, Reston Hospital and Surgery Center, and Stone Springs.

 

Va Healthcare Exchange Prices

HMOs In Virginia Reduce Healthcare Costs

 

VHI also plays a vital role in helping consumers compare HMOs in Virginia. There are specific differences in benefits and cost, but also the network of providers along with the type of treatment that is administered. Some of the major HMO plans in the state are listed below:

Aetna

Kaiser

UnitedHealthcare

Innovation

CareFirst BlueChoice

Optima Health Plan

Optima Choice

HealthKeepers

When reviewing and comparing different HMOs, the amount of criteria used can be overwhelming. Some of the topics VHI uses include:

Preventive Care

Immunizations

Pediatric Illnesses

Alcohol and Drug Treatment

Obesity and Weight Assessment Counseling

Diabetes Care And Treatment

Lower Back Pain

Provider Board Certification Rates

Usage Of Medications

Mental Health Diagnosis And Treatment

Rheumatoid Arthritis Treatment

ADD and ADHT Medication
 

Hospitals
 

One of the most comprehensive topics covered are Virginia hospitals. In addition to helping you choose the best facility, you can also learn about ratings and how to interpret results, determining the best facility for your treatment, and the difference between community and teaching hospitals. There are downloadable guides to assist and provide specific points of interest.

Data is divided into two components. They are "Hospital Specialty Service" and Psychiatric Hospital Diagnostic." Technical procedures are excluded, and an extensive checklist and comparison sheet helps you review nurse-to-patient ratios, modernization of facilities, percentage of physicians that are board-certified, and national accreditation information. A printer-friendly version is available upon request. A hospital-rating worksheet is also available for consumers to evaluate their experience following a short-term or long-term visit. Many of the topics reviewed are listed below:
 

Insurance coverage
Latest equipment
Certified teaching facility
Nurse to patient ratio
Percentage of board-certified doctors
Seminars and classes available
Free diagnostics available
Friendliness of staff
Religious affiliation similar to treated patient
Location
Age of facilities
Wellness program
Free television
Accommodations for relatives
Flexible visiting hours
Cafeteria and room food menu
Patient privacy
Clinical trial participation opportunities
Private room availability
Access to safe for personal valuables

 

Virginia Hospital Patient Satisfaction Ratings
 

Show below are the hospitals with the highest percentage of patients who rated the facility at least 9 out of 10 (scale of 1-10 with 0 the lowest rating and 10 the highest rating).
 
82% -- Virginia Hospital Center
81% -- Smyth County Community Hospital
80% -- Carilion Giles Community Hospital
80% -- Riverside Shores Memorial Hospital
78% -- Inova Fairfax Hospital
78% -- LewisGale Hospital Pulaski
78% -- Sentara Martha Jefferson Hospital
78% -- Sentara Princess Anne Hospital
77% -- Bon Secours St. Francis Medical Center
77% -- Inova Fair Oaks Hospital
77% -- Inova Mount Vernon Hospital
77% -- Sentara Leigh Hospital
77% -- Sentara Williamsburg Regional Medical Center
77% -- Stone Springs Hospital Center
76% -- LewisGale Hospital Montgomery
76% -- Sentara Norfolk General Hospital
76% -- University Of Virginia Medical Center
75% -- Carilion Franklin Memorial Hospital
75% -- Sentara CarePlex Hospital
75% -- VCU Medical Center
75% -- Wellmont Lonesome Pine Mt. View Hospital
74% -- Carilion Stonewall Jackson Hospital
74% -- Henrico Doctor's Hospital
74% -- Inova Loudoun Hospital
74% -- Norton Community Hospital

 

HMO Member Satisfaction
 

Aetna -- 88.1%
Optima Health -- 87.1%
CareFirst BlueChoice -- 84.6%
Optimum Choice -- 84.0%
Kaiser -- 83.7%
UnitedHealthcare -- 82.2%
HealthKeepers -- 81.2%

 

PAST UPDATES:
 
The Industry report is now available. Employers and buyers of healthcare products often use these reports as a valuable tool and guideline for managing expenses and offering the best available products. The top-ranked hospitals from the latest report include Virginia Hospital Center, Bon Secours Memorial Regional Medical Center, Riverside Walter Reed, Norvant Prince William Medical Center, and Carilion Franklin Memorial.
 

A report on Clostridium difficile (C.diff) is available for viewing and downloading. This bacteria can lead to serious health issues if not treated quickly and properly. Hospital confinements in Virginia have tripled in the last 10-15 years for this conditions so educating the public is important.
 

The American Cancer Society released a report indicating that rectal and colon cancer rates are increasing for under age 55 adults. Not utilizing preventative healthcare benefits appears to be one of several relevant factors. A recommended colonoscopy is 100% covered on all qualified private and group health insurance plans. In the most recent HMO report for the state, about two out of three residents between the ages of 50 and 80 received regular colorectal cancer screenings.
 

You can download the pdf file here. Although the riskiest period ends in a few months, proper use of antibiotics will substantially reduce your risk. Most infections occur in a hospital, doctor's office or other place of treatment.