Category Archives: Health care reform

HuffPost dives into public records on King v. Burwell

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 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

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.

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

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.

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

2014 winners named in top health journalism awards

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

awardsSoaring drug prices that make even copays unaffordable for many, an unchecked rise in robotic surgery, financial abuse revealed using previously secret Medicare data, and the health ramifications of the boom in hydraulic fracturing for oil were among the top winners of this year’s Award for Excellence in Health Care Journalism.

Awards also went to articles that examined the “collateral damage” of urban violence, followed a team of doctors and scientists fighting Ebola, and exposed the growing number of unregulated diagnostic tests that can lead to patient harm.

Read the full announcement and see the winning entries. Congratulations to all of the winners!

Health Journalism 2015 agenda covers gamut of health care

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

<span class="credit">Pia Christensen/AHCJ</span>AHCJ President Karl Stark, the assistant managing editor, business, health and science at <em>The Philadelphia Inquirer</em>, gives tips on covering hospital finance at Health Journalism 2014.

Pia Christensen/AHCJAHCJ President Karl Stark, the assistant managing editor, business, health and science at The Philadelphia Inquirer, gives tips on covering hospital finance at Health Journalism 2014.

We have posted descriptions of nearly all of the panels planned for Health Journalism 2015 and it’s an agenda packed with timely and useful sessions for anyone covering health.

Field trips on Thursday will feature trips to Stanford University, Lucile Packard Children’s Hospital, Stanford Health Care, Stanford National Accelerator Laboratory, the Division of Clinical Anatomy at Stanford University and the VA Palo Alto Health Care System to learn about simulation training, pediatric heart care, hospital disaster preparation, veterans’ rehabilitation, early detection of cancer and much more. Continue reading

Finding the full story behind hospital mergers, consolidations

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.

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.

The other part of health reform: Changing the delivery of care

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

AHCJ webcastReforms to the health care delivery system have been overshadowed by the Affordable Care Act enrollment story but there are stories galore to be found.

The 2010 law takes steps to shift how we deliver health care – to do a better job of managing chronic diseases, to make hospitals safer, to move away from fee-for-service, to get more quality for our health care spending. It’s a big challenge but it doesn’t get as much attention as the coverage aspects of the ACA, partly because it’s not so politically radioactive.

Join Joanne Kenen, AHCJ’s health reform core topic leader, and Patrick Conway, M.D., M.Sc., director of the Center for Medicare and Medicaid Innovation, for a discussion on new ways of delivering care, evaluating what works and some early results. Health care providers around the country are taking part in CMMI initiatives and private sector counterparts.  There will be plenty of time for questions from participants during this members-only webcast.

How close are we to meeting the promise of electronic health records?

Carla K. Johnson

About Carla K. Johnson

Carla K. Johnson (@CarlaKJohnson) is a medical writer at The Associated Press and has covered health and medicine since 2001. She is a member of AHCJ's board of directors, serving as liaison to the association’s local chapters and leading the one in Chicago.

Photo: Carla K. JohnsonA panel of experts discusses health information technology at an AHCJ Chicago chapter event on March 3 in Chicago. From left: Dr. Arnold “Ned” Wagner Jr., chief medical information officer, NorthShore University HealthSystem; Dr. Diane Bradley, senior vice president, chief quality and outcomes officer, Allscripts; Eric Yablonka, vice president and chief information officer, University of Chicago Medicine; and moderator Neil Versel, an independent journalist.

Photo: Carla K. JohnsonA panel of experts discuss health information technology at an AHCJ Chicago chapter event on March 3 in Chicago. From left: Dr. Arnold “Ned” Wagner Jr., chief medical information officer, NorthShore University HealthSystem; Dr. Diane Bradley, senior vice president, chief quality and outcomes officer, Allscripts; Eric Yablonka, vice president and chief information officer, University of Chicago Medicine; and moderator Neil Versel, an independent journalist.

Yes, technology is transforming health care. No, we haven’t come anywhere close to realizing the vision.

Smooth patient handoffs, data-driven performance improvement and real-time analytics are still mostly dreams, although those ambitions have been talked about for years.

Independent journalist Neil Versel, who specializes in health information technology, moderated a panel on March 3. The AHCJ Chicago chapter event was held at AMA Plaza, the new headquarters of the American Medical Association.

Electronic medical record systems “need to play nicer together so they can use each other’s information as if it was natively generated,” said Arnold “Ned” Wagner Jr., M.D., chief medical information officer of NorthShore University HealthSystem. “Can we talk to each other transparently? Well, partly. The success of communication depends on human behavior and (technology’s) job is to help understand the reality of what motivates people to do things.” Continue reading

SCOTUS: Some things to note as we wait for a decision

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.

By Steve Petteway, Collection of the Supreme Court of the United States (Roberts Court (2010-) - The Oyez Project) [Public domain], via Wikimedia Commons

By Steve Petteway, Collection of the Supreme Court of the United States (Roberts Court (2010-) – The Oyez Project) [Public domain], via Wikimedia Commons

On March 4 the Supreme Court heard oral arguments in King v. Burwell. A ruling is expected in late June – though it’s possible it could come earlier. The plaintiffs argue that the health insurance subsidies should only be available to people living in states running their own Affordable Care Act health insurance exchanges or marketplaces, not the 34 states using the federal exchange via HealthCare.gov. They cite four words in the text of the law “established by the state” to make this argument. The Administration says it’s clear from reading the full text of the 906 page law that subsidies were to be available in all 50 states, no matter what kind of exchange they have.

So the Supreme Court has heard the King v. Burwell challenge to the Affordable Care Act.

Now what?

Good question.

Much of the coverage suggested that the March 4 oral arguments seemed to favor the administration, particularly because Justice Anthony Kennedy, often the deciding swing vote on the court, asked some questions showing skepticism of the plaintiff’s case.

But all that tells is precisely that – he asked some questions showing skepticism. He won’t necessarily vote that way. He backed scrapping the entire statute back in 2012 and made clear at that time that he detested the law.

Oral arguments are interesting and important – but rarely decisive. If you think you know how the court will rule – well you have a 50-50 chance of being right.

A few things did come out that health journalists should note. Continue reading

When hospitals buy physician practices, patients hit with fees

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" PINKÉ via Flickr

Photo: PINKÉ via Flickr

WSB-Atlanta recently explored what happens when hospitals buy physician practices, which has been happening all over the Atlanta area.

Prices for patients go up.

The same physicians – in the same offices, with the same treatments – start charging more.

“Everything is exactly the same,” said cancer patient Mike Rosenberg.

Except the bill.

Sometimes it’s an “outpatient facility fee.” And sometimes it’s a “treatment room fee.”

And it’s a lot of money – sometimes thousands of dollars, not covered by insurance.

And even patients who are savvy enough to know about these fees before they get the bill have a lot of trouble finding out about them, as Erica Byfield made clear in her strong 3-minute report.


A map shows facilities owned by, operated by, or affiliated with hospitals. (Yellow: Emory, Red: WellStar, Purple: Piedmont, Blue: Gwinnett Medical, Green: Northside)

It’s not unique to Atlanta. She quotes a University of California, Berkeley, study that found that patients generally pay 10 percent more at hospital-owned practices.

Byfield doesn’t explore whether the push for hospitals to purchase practices is related to the Affordable Care Act – she just says in passing that it’s unclear how big a role the law plays.

Actually the ACA does include incentives for “vertical integration,” or having doctors and physicians part of one organization. But it’s not supposed to raise costs. It’s supposed to bring them down by improving efficiency, creating economies and encouraging care coordination. (Some of the fee problems actually stem from Medicare billing practices, not specifically the ACA.)

Last year Daniel Chang of The Miami Herald looked into integration of hospitals and physician practices – and found patients in Florida were getting hit by big fees. He wrote a “How I did” it piece for us.

If you want to look at this in your community, it’s a good story.

Advocacy groups can help you find patients. And you can just try calling yourselves and seeing if the hospitals and physician practices will talk about their policies. Only two of the big Atlanta-area hospitals were forthcoming with the Atlanta station – and they reported that, and put the policies that were shared up on the web.

Note: I periodically request that people bring good local television coverage of health care to my attention, so we’re not so print (and a dash of public radio) focused. Now I can’t remember who highlighted this one – it may have been on @charlesornstein’s Twitter feed. But please do send good work my way (joanne@healthjournalism.org), we’d like to include it.