Author Archives: Joanne Kenen

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 She welcomes questions and suggestions on health reform resources and tip sheets at

What that recent emergency department survey didn’t tell us

emergency-roomEarlier this month many of us received a news release from the American College of Emergency Physicians about a survey that indicates emergency department visits are rising along with coverage expansion under the Affordable Care Act. This was happening even though one important goal of the health law is to connect people with primary care physicians so they wouldn’t feel compelled to go to the ED for primary care.

While many of us ignored the release or, at most, wrote a brief; some large news outlets did give the survey big play, even linking the increase to expanded Medicaid coverage. The tone of that coverage, at least in a few pieces I saw, was that this was a negative development. Continue reading

The ACA and patient satisfaction: Does it improve care?

Alexandra Robbins

Alexandra Robbins

The ACA made many changes to Medicare. One of them involves linking part of hospital pay to patient satisfaction.

In an Atlantic magazine essay adapted from her new book, “The Nurses: A Year of Secrets, Drama, and Miracles With the Heroes of the Hospital,” Alexandra Robbins argues that hospitals are missing the point: the way hospitals are defining, measuring and achieving patient “satisfaction” is not advancing the quality of care.

Robbins overstates that the amount of Medicare payments tied to patient satisfaction and understates the role of outcomes (more on Medicare’s Hospital Value-Based Purchasing later). But her essay is provocative and worth thinking about for those of you who cover the hospital industry or your local hospitals, and how they are changing under the Affordable Care Act. Continue reading

Conference panel generates ACA resources, story ideas #ahcj15

Anyone who is moderating a session at an AHCJ conference is lucky to have AHCJ board member, Associated Press medical writer, and Twitter extraordinaire Carla K. Johnson (@CarlaKJohnson) in the audience. Here, she’s Storified her Twitter stream from the session “Politics, Policy and People: ACA report card.”

Our speakers were David Blumenthal, M.D., president of The Commonwealth Fund; Mollyann Brodie, Ph.D., senior vice president for executive operations, Kaiser Family Foundation (she oversees its polling); and Lanhee Chen, Ph.D., David and Diane Steffy research fellow, Hoover Institution. On Twitter, they are @DavidBlumenthal, @mollybrodie and @lanheechen. Continue reading

Reporters offer state, local story ideas for covering ACA #ahcj15

The first day of Health Journalism 2015 featured a session “The ACA: Will it survive? And how to cover it now” with Kaiser Health News’s Julie Appleby and Vox’s Sarah Kliff. Their major themes included:

Julie Appleby & Sarah Kliff

Julie Appleby & Sarah Kliff

  • The King v. Burwell Supreme Court case over federal subsidies
  • What’s next in Congress?
  • Exchanges
  • Medicaid
  • And – the topic that got by far the most attention from the crowd – narrow networks.

Here are some of their highlights and story suggestions, with an emphasis on stories that state and local reporters can tackle. (Here are Kliff’s slides.) Continue reading

VA secretary addresses some of department’s challenges #ahcj15

Photo: Pia ChristensenRobert McDonald

Pia Christensen/AHCJRobert McDonald

More than 140 journalists at Health Journalism 2015 gathered early Friday to hear Veterans Affairs Secretary Robert McDonald – and to question him about VA policies, including the agency’s notorious opaqueness with reporters.

McDonald readily acknowledged that the VA has had what he called a “Kremlin-esque” mentality, and told the roomful of journalists that he was trying to change it. The VA is publishing patient access data (waiting times for appointments) on the website every two weeks, and he said he’s trying to promote a culture of openness. Continue reading

Maintaining Medicaid ‘bump’ a state-by-state endeavor

Medicaid pay rates for doctors in many states traditionally have been extremely low – so low that most physicians didn’t want to participate in the program, or take on more Medicaid patients than they already had.

Joe Moser

According to the Kaiser Family Foundation, Medicaid had paid only 59 percent of what Medicare did for primary care before that.

The Affordable Care Act raised the rates for primary care providers to be equal to Medicare pay. Medicaid had paid only 59 percent of what Medicare did for primary care before that, according to the Kaiser Family Foundation. The snag: the Medicaid “bump” lasted for only two years, until the end of 2014. And Congress has not renewed it, although there has been a bit of preliminary talk about it. Continue reading

HuffPost dives into public records on King v. Burwell

Photo by dbking via Flickr

Photo by dbking via Flickr

A key issue in King v. Burwell, the health care reform case argued before the Supreme Court in early March, is whether Congress intended to make certain subsidies available to eligible people across the country or only to those living in states that created their own health insurance exchange.

Sam Stein and colleagues at the Huffington Post filed public record requests with several key states, including some  in which prominent GOP governors did not establish exchanges. The reporters also reviewed records from the U.S. Department of Health and Human Services and more than 50,000 previously released emails from the Oklahoma governor’s office. The requests covered a period between the March 2010 passage of the Patient Protection and Affordable Care Act and August 2011, when the IRS ruled that the subsidies should be available in all states.

How much discussion did Stein find about the risk of losing subsidies? Continue reading

ACA changes on the way, CMS official says

We tend to focus on the Affordable Care Act as a law that simply gives more people health insurance – and it has.

But as we’ve noted before, the health reform law also contains all sorts of programs and provisions that aim to change how health care is delivered: how we pay, what we pay for, and how we shift from a hospital-centric acute care system to one that stresses prevention, wellness and care and management of chronic diseases. Examples can be found across the country.

At a recent AHCJ webinar, Patrick Conway, M.D., deputy administrator of the Center for Medicare and Medicaid Services, gave an overview of some of the changes underway. Conway, whose job includes oversight of the Center for Medicare and Medicaid Innovation, also announced the next big thing in Accountable Care Organizations. More on that below. Continue reading

Breaking down restaurant fees the way hospitals do

Image: WHYY’s The Pulse & Don Greenfield

Image: WHYY’s The Pulse & Don Greenfield

It’s not often that we can tell you something about health care prices and also make you laugh … but we spotted a link to this on Twitter the other day and it’s priceless (no pun intended).

You all know by now that hospital bills make little sense, and that fee for service has its … shall we say … absurdities. Continue reading

Finding the full story behind hospital mergers, consolidations

Dan Goldberg

Dan Goldberg

Across the country, health systems are getting larger, gobbling up community hospitals or smaller chains. Some of this has to do with payment incentives in Obamacare, but just as much has to do with changes to Medicare, Medicaid and providers’ desire for leverage as they negotiate payments with insurance companies.

In the February issue of Capital Magazine, reporter Dan Goldberg looked at  New York’s five large health systems and the strategies they were employing to diversify their revenue base while preparing to play in a post-ACA, value-based world.

No chief executive, whether for-profit or not, wants to lose money. So every deal they make generally has financial reasoning behind it, and every deal they don’t make usually carried some financial risk that seemed too great to bear. In this new tip sheet Goldberg shares some questions to keep in mind for reporters looking at the new business landscape.