Does UnitedHealthcare’s prior-approval rule mean more ‘mother-may-I’ medicine is coming?

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Photo: U.S. Pacific Fleet via Flickr

Photo: U.S. Pacific Fleet via Flickr

The nation’s largest health insurer will require physicians and hospitals to request prior approval before doing most hysterectomies, a move that may indicate a trend toward more pre-authorization for tests and procedures.

In a statement posted on its website, UnitedHealthcare cited evidence from the American Congress of Obstetricians and Gynecologists (ACOG) that shows better patient outcomes and fewer complications from vaginal hysterectomies than with laparoscopic or abdominal hysterectomies. The requirement for prior approval will be effective April 6. Patients undergoing outpatient vaginal hysterectomies do not need prior authorization, UHC said. Continue reading

Talking about end of life and palliative care: Part two of a conversation with Nancy Berlinger

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in Kaiser Health News, The Atlantic.com, New America Media, AARP.com, Practical Diabetology, Home Care Technology report and on HealthStyles Radio (WBAI-FM, NYC). She is a senior fellow at the Center for Health, Media & Policy at Hunter College, NYC, and a co-produces HealthStyles for WBAI-FM/Pacifica Radio.

Photo: James Hancox via Flickr

Photo: James Hancox via Flickr

Nancy Berlinger, Ph.D., is a research scholar at The Hastings Center and co-author of a retrospective article on palliative and end-of-life care that was published in the Feb. 12 New England Journal of Medicine.

In part one of our conversation, Berlinger focused on the need to broaden the discussion among and improve training of clinicians on talking to patients about end of life issues. In part two, she discusses foreseeable scenarios, societal perspectives and how to improve media coverage of this complex topic. Continue reading

Four insurers reveal what they pay for 70 health care services

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

Photo by Truthout.org via flickr.

Photo by Truthout.org via flickr.

Health insurers are taking incremental steps to release information on what they pay to health care providers. Each month, they reveal just a bit more.

This week, Aetna, Assurant Health, Humana and UnitedHealthcare released state and local cost information through the nonprofit Health Care Cost Institute (HCCI) on a consumer site called Guroo.com. The data show the costs for about 70 common health conditions and services and are based on claims from more than 40 million insured individuals, HCCI announced.

No other organization has made these data available, HCCI said. In that way, this release is significant. Or, as the Guroo site says of the data: “The biggest collection of cost information is now at your fingertips, so you know what care really costs.”

Well, not exactly. The data show what insurers paid. Or, as Jason Millman pointed out in The Washington Post, “The site doesn’t break down what a consumer pays for services versus what the insurer pays.” Continue reading

SCOTUS decision on teeth-whitening business may hold wider implications for medical boards

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Image by waldopepper via Flickr

Image by waldopepper via Flickr

Lisa Schencker of Modern Healthcare  and Anne Blythe of the Raleigh News & Observer were among the first reporters to get the news out.

Today, the U.S. Supreme Court ruled that the North Carolina state dental board does not have the authority to regulate teeth-whitening businesses.

In a 6-3 decision, the justices found the North Carolina Board of Dental Examiners, which is comprised mostly of dentists, illegally quashed competition from non-dentists who sought to open teeth-whitening shops in the state. The decision, which upheld a lower court’s ruling, has the potential to impact other professional licensing boards across the country, experts say. Continue reading

AHCJ mourns journalist Dori J. Maynard

Len Bruzzese

About Len Bruzzese

Len Bruzzese is the executive director of AHCJ and its Center for Excellence in Health Care Journalism. He also is an associate professor at the Missouri School of Journalism and serves on the executive committee of the Council of National Journalism Organizations.

Dori Maynard

Dori J. Maynard

AHCJ laments the passing of Dori J. Maynard, longtime journalist and president of the Robert C. Maynard Institute for Journalism Education. Maynard died Tuesday of lung cancer at 56. She and the organization named for her father pushed for diversity in journalism coverage and newsroom staffing.

A champion of journalism education, she led the Fault Lines project, which seeks to teach journalists to recognize and leverage diversity “across the ‘fault lines’ of race, class, gender, generation and geography.” She was a 1993 Nieman fellow, following in the footsteps of her father, who was a fellow in 1966.

As a reporter, she worked at The Bakersfield Californian, The Patriot Ledger in Quincy, Mass., and the Detroit Free Press.  Maynard attended AHCJ events as an AHCJ Ethnic Media Fellow, as an annual conference speaker and as a co-sponsor of a workshop on multicultural health. Her contributions will be missed.

Momentum grows to establish dental therapists; what about your state?

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

Image by  Herry Lawford via flickr.

Image by Herry Lawford via flickr.

Mid-level dental providers are at work in countries from the United Kingdom to Malaysia. Here in the United States, advocates are pushing hard to get states to enact laws that would open the way for dental therapists to get care to people who might otherwise go without it.

Organized dental groups, including the American Dental Association have fought the model, contending that only dentists have the training to perform what are termed irreversible procedures such as drilling and extracting teeth.

Even so, dental therapists, who provide care under the general supervision of dentists, are now treating patients in tribal areas of Alaska as well as in poor communities in the state of Minnesota. Maine has also passed legislation and is moving forward with therapists.

Meanwhile, other states are considering the model. Is yours one of them?

There is a lot going on in this area to write about, so this seems like a good time to offer a tip sheet that features some of the latest coverage and resources that might help you explore this topic.

Experts weigh in on covering the SCOTUS challenge

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org.

Photo: Seth Borenstein, Associated Press/New York UniversityPhil Galewitz, of Kaiser Health News; Tom Goldstein, an attorney and founder of SCOTUSblog; Christine Eibner, a senior economist at Rand Corp.; and Thomas Miller, a fellow at the American Enterprise Institute (left to right) discussed how to cover Burwell vs. King Supreme Court Case during a chapter event at the NYU Washington, D.C., Center on Feb. 18.

Photo: Seth Borenstein, Associated Press/New York UniversityPhil Galewitz, of Kaiser Health News; Tom Goldstein, an attorney and founder of SCOTUSblog; Christine Eibner, a senior economist at Rand Corp.; and Thomas Miller, a fellow at the American Enterprise Institute (left to right) discussed how to cover King v. Burwell at the NYU Washington, D.C., Center on Feb. 18.

The Washington, D.C., chapter of the Association of Health Care Journalists had a session last week about the upcoming King v. Burwell case that will go before the Supreme Court challenging whether the Affordable Care Act subsidies can flow through the federal exchanges.

More than 30 people attended the event at New York University’s D.C. campus, including some students and faculty, and it was mentioned in Politico Pulse. Seth Borenstein, a science writer for The Associated Press and adjunct professor, helped organize and co-host the session. Kaiser Health News reporter Phil Galewitz, who leads the D.C. chapter, and Margot Sanger-Katz, a health writer with The New York Times, spoke to students after the event about how journalists have covered the Affordable Care Act.

A ruling for King would affect people in 34 states. Three other states – Nevada, New Mexico and Oregon – are using HealthCare.gov technology but are running enough of their own exchange to be a sort of hybrid. Briefs for both sides filed in the case agree that it will affect 34 states, not 37.

We’re assembling a tip sheet with more resources on the case, but here are some highlights from the event. Continue reading

Welcoming AHCJ’s newest members

Len Bruzzese

About Len Bruzzese

Len Bruzzese is the executive director of AHCJ and its Center for Excellence in Health Care Journalism. He also is an associate professor at the Missouri School of Journalism and serves on the executive committee of the Council of National Journalism Organizations.

Please welcome these new professional and student members to AHCJ. All new members are welcome to stop by this post’s comment section to introduce themselves.

  • Laine Bergeson, news producer, BringMeTheNews, Minneapolis (@lainebergeson)
  • Maggie Clark, business of health reporter, Sarasota Herald-Tribune, Sarasota, Fla. (@maggieclark320)
  • Naomi Cohen, student, Columbia University, Los Altos, Calif.
  • Folasade Falebita, student, Columbia University, Jersey City, N.J. (@sadefalebita)
  • Michelle Faust, reporter/producer, WXXI Public Broadcasting, Rochester, N.Y. (@michereports)
  • Cynthia McKelvey, science journalist, Multiple Sclerosis Discovery Forum, Berkeley, Calif. (@NotesofRanvier)
  • Roger Plothow, editor and publisher, Post Register, Idaho Falls, Idaho (@rdplothow)
  • Guimel Sibingo, student, University of Missouri, Columbia, Mo.
  • Nancy Stedman, deputy editor, health, More Magazine, New York

If you haven’t joined yet, see what member benefits you’re missing out on: Access to more than 50 journals and databases, tip sheets and articles from your colleagues on how they’ve reported stories, conferences, workshops, online training, reporting guides and more. Join AHCJ today to get a wealth of support and tools to help you.

Investigating the health impacts of fracking

Kris Hickman

About Kris Hickman

Kris Hickman (@the_index_case) is a graduate research assistant for AHCJ, pursuing a master’s degree in public health. She has a bachelor's degree in anthropology, with a minor in journalism, from the University of Missouri. She spent two years in Zambia as an HIV/AIDS community education volunteer in the Peace Corps. She aspires to be an epidemiologist and science writer.

Pia Christensen/AHCJ

Pia Christensen/AHCJ

The fracking controversy has been high profile in recent years, and tempers are short on all sides of the subject. Some groups see natural gas and the process used to extract it – hydraulic fracturing, or “fracking” – as a boon to energy production in the U.S., while others see it as a pernicious threat to people and the environment.

As shown in this New York Times interactive infographic, fracking (sometimes called “unconventional gas drilling”) is a complicated process. It involves high-pressure injection of fluids into natural gas reserves that lie thousands of feet underground, trapped in layers of shale. In addition, there’s a landslide of conflicting information and anecdotal evidence.

So, as a reporter, how do you sift through the various interests and pull out a story that is relevant to your community?

Continue reading

A problem with precision medicine: It’s not quite precise – at least not yet

Joseph Burns

About Joseph Burns

Joseph Burns (@jburns18), a Massachusetts-based independent journalist, is AHCJ’s topic leader on health insurance. He welcomes questions and suggestions on insurance resources and tip sheets at joseph@healthjournalism.org.

At a conference last year, Michael Laposata, M.D., Ph.D., one of the nation’s best known pathologists, explained how clinical laboratories could deliver more value to patients, physicians, and health insurers. To do so, pathologists and laboratory scientists need to provide more detailed explanations about lab test results because even physicians who order genetic and molecular tests are often confused about the results, said Laposata, chairman of the Department of Pathology at the University of Texas Medical Branch.

When he explains test results to ordering physicians, he frequently refers to an “allele” which is one of two or more versions of a gene, he said. When he does, physicians sometimes ask, “What’s an allele?”

His anecdote is telling following President Obama’s announcement last month that he recommended spending $215 million on the precision medicine initiative. The announcement was correctly hailed as an important and needed investment in medical technology. “Precision medicine” is described by the National Institutes of Health as “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.” Continue reading