Category Archives: Government

VA secretary addresses some of department’s challenges #ahcj15

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: 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

Native American tribe wields sales tax to promote healthier eating

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  Mike Licht via flickr.

Image by Mike Licht via flickr.

Hoping to encourage healthier eating habits, leaders of the Navajo Nation have imposed a potentially precedent-setting tax on junk food and sodas.

The 27,000-square-mile territory, which extends into Utah, Arizona and New Mexico, as of April 1 added a 2-cent sales tax to an existing 5-cent sales tax on most goods sold there, Eliza Barclay reported for National Public Radio’s food blog, The Salt. Fresh fruits and vegetables sold on the reservation have been tax-free since October as part of the tribe’s healthy eating initiative. Continue reading

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

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

Journalists’ coverage of prenatal screening uncovers big gaps in what we know about genetic testing

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 mahalie stackpole via Flickr

Photo by mahalie stackpole via Flickr

Last month, journalists from the New England Center for Investigative Reporting raised serious questions about prenatal genetic screening tests, saying physicians and patients may not fully understand the results of these tests for fetal abnormalities.

In their reporting, the journalists exposed a symptom of what may be a bigger problem: the proliferation of genetic tests without a full understanding about what such testing can and cannot do. Even health insurers have struggled to understand how to pay for new genetic tests.

The stories also pointed out that federal regulators are wrestling with how to classify genetic tests. Many of these tests fall into the category of what pathologists call lab-developed tests or LDTs. These tests are not regulated by the FDA, as the NECIR journalists reported. In October, the FDA proposed regulating these tests as medical devices and clinical laboratories are pushing back, saying such regulations could interfere with the practice of medicine.

We’ll address these issues one at time. Continue reading

Hospital survey data updated, with changes

Jeff Porter

About Jeff Porter

Jeff Porter is the special projects director for AHCJ and plays a lead role in planning conferences, workshops and other training events. He also leads the organization's data collection and data instruction efforts.

AHCJ has just updated its easy-to-use Hospital Consumer Assessment of Health Providers and Systems (HCAHPS) survey data to include the latest release of the data by the U.S. Centers for Medicare and Medicaid Services and reflect changes in the data by CMS.

The data include survey questions about how doctors and nurses communicate, how hospitals are controlling patients’ pain, how hospitals are keeping clean and quiet, and more. AHCJ also creates a spreadsheet file that contains a timeline of the overall ratings of hospitals, with results from October 2006 to September 2013.

Each data release now includes the beginning and ending dates covered in the survey. The latest hospital survey results cover Oct. 1, 2012, through Sept. 30, 2013.

Caution in order when tackling newly released Medicare data

Charles Ornstein

About Charles Ornstein

Charles Ornstein is a senior reporter with ProPublica in New York. The Pulitzer Prize-winning writer is a member and past president of the Association of Health Care Journalists' board of directors and a member of its Right to Know Committee.

AHCJ hosted a webcast about the CMS data, featuring several CMS officials and Charles Ornstein, a senior reporter at ProPublica and member of AHCJ’s board of directors.

The federal government is expected Wednesday to release data on the services provided by – and money paid to – 880,000 health professionals who take care of patients in the Medicare Part B program. For 35 years, this data has been off limits to the public – and now it will be publicly available for use by journalists, researchers and others.

While the data offers a huge array of stories, which could take weeks or months to report out, it also has some pitfalls. Here are six things to be aware of before you dig in:

Have a strategy for storing and opening the data. This data set is big. About 10 million rows, from what I hear. Because of that, you won’t be able to analyze it in Microsoft Excel and you might not be able to open it in Microsoft Access. You’ll want to upload it onto a data server and analyze it in a more powerful program such as SQL or SPSS. This could well serve as a barrier to entry for smaller news organizations. You may want to partner with an academic institution or another news outlet to analyze the data. Continue reading

Court ruling may signal tougher stance on hospital-physician ventures

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.

Image by SalFlako via flickr.

Image by SalFlako via flickr.

One of the most significant trends in health care over the past few years has been the merger of physician groups with hospitals. By acquiring physician groups, hospitals and health systems can develop accountable care organizations and gain a competitive advantage by requiring employed physicians to refer patients to them.

But last week a federal judge in Idaho ruled that St. Luke’s Health System in Boise had violated antitrust law by acquiring the 40-physician Saltzer Medical Group, in nearby Nampa, Idaho, in December 2012. At the time, Saltzer was the largest independent multispecialty group practice in the state. As result of the antitrust violation, the judge said the hospital had to unwind the acquisition.

Given that the Federal Trade Commission was a plaintiff in the case, the decision raises a question about whether the FTC will pursue antitrust cases in other cases when hospitals acquire physician groups. The decision on Friday by B. Lynn Winmill, chief judge of the U.S. District Court in Idaho, marked the first time a federal court had decided an FTC case against a hospital acquiring a physician practice, as Beth Kutscher explained in Modern Healthcare. Continue reading

Media groups decry CDC’s silence on W.Va. spill; agency admits communication missteps

Felice J. Freyer

About Felice J. Freyer

Felice J. Freyer is a member of AHCJ's board of directors, serving as vice chair of the organization's Right to Know Committee. She is a medical writer for The Providence (R.I.) Journal.

The recent chemical spill in West Virginia, which contaminated the drinking water of 300,000 people, became another occasion when federal agencies shut the door on reporters seeking answers, fueling public anxiety with their silence.

But after complaints from journalism organizations, including AHCJ, the U.S. Centers for Disease Control and Prevention this week issued a mea culpa and a pledge “to work to reach that critical balance between accuracy and timely release of information the public expects and needs to protect their health.”

The CDC told West Virginia health officials on Jan. 15 that pregnant women should not drink the water until the chemical, called Crude MCHM, was at “nondetectable levels.” Reporters from the Charleston (W.Va.) Gazette had a lot of questions about this order – but could get no answers from the CDC press office. Continue reading

What we know – and a bit of what we don’t – about HealthCare.gov

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.

healthcare-dot-gov-codeI’m not particularly tech savvy but, one month into the HealthCare.gov website mess, here’s some of what I think we do know now – and what we are still waiting to find out.

Traffic: Volume was high, and it was one reason for the system’s poor performance. But it was not the only reason, not by any means. Nor have I seen a convincing explanation for why the administration low-balled the traffic expectations.

Code: There are millions of lines of it and it’s a mess. It’s being rewritten/worked-around. We don’t know much more than that. Continue reading