It’s hard to think clearly about health reform if you ignore the social determinants of health, that is, how each person’s place in the hierarchy of self-determination and power, educational opportunity, neighborhood quality, working conditions, job security, income and wealth shape their vulnerability to illness and premature death. Check your knowledge by taking this true-or-false quiz: Continue reading
ClearHealthCosts.com was started by former New York Times reporter and editor Jeanne Pinder. She received start-up funding from foundations (Tow-Knight Center for Entrepreneurial Journalism at CUNY and others listed on the website) and ClearHealthCosts now has a team of reporters and data wranglers chipping away at some of the difficult questions that patients need answered: How much is this treatment going to cost me? Can I find a better price?
It’s about shedding light on a health care cost and payment system that, to use Pinder’s word, is “opaque.” Some of what they are doing is specific to a half-dozen cities; other projects are building out nationally.
The data collected by ClearHealthCosts focuses on elective or at least nonemergency procedures such as imaging, dental work, vasectomy, walk-in clinics, screening (mammograms and colonoscopy) and blood tests. Much of the data is crowdsourced, and focused on New York area, including northern New Jersey and other suburbs; the San Francisco and Los Angeles areas; and Houston, Dallas-Fort Worth, Austin and San Antonio in Texas.
A recent grant from the John S. and James L. Knight Foundation via its Prototype Fund will let ClearHealthCosts collaborate with KQED in San Francisco and KPCC/Southern California Public Radio in Los Angeles to crowdsource Califoria prices. Earlier, Pinder’s team did a crowdsourcing partnership with the Brian Lehrer Show at WNYC public radio in which hundreds of women shared mammogram payment information, and their thoughts. It led to a series of blog posts including here and here. Continue reading
A couple of stories have begun to trickle out from states about the impact of Medicaid expansion on hospitals.
This one from the Arizona Daily Star by Stephanie Innes, for instance, reports that uncompensated care dropped by a third in the first four months of 2014 from the prior year – a pretty significant number. The hospitals in that period wrote off $170 million in 2014, versus $246 million from Jan through April in 2013.
She uses data from the state’s hospital industry to report on uncompensated care (both bad debt and uncompensated care) and the hospitals’ bottom line.
“The Arizona hospital report shows the average operating margin of Arizona hospitals has gone up from 4 percent in 2013 to the current rate of 5.2 percent — a signal to some health experts that the Affordable Care Act will be a net positive for hospitals’ bottom lines,” she wrote. Continue reading
When Illinois awarded a $33 million contract to a high-priced PR firm to promote insurance coverage under the Affordable Care Act, Carla Johnson began filing open records requests under the state’s Freedom of Information law.
Eventually Johnson, a medical writer for The Associated Press, filed 10 FOIA requests while reporting on how public money was spent to promote the health law.
She says the “88-page contract, obtained through a records request, contained clues about other existing documents, such as monthly detailed explanations of invoices and a ‘work plan’ required by the contract.” She continued filing requests until she had enough documentation to detect some trends.
We posted some data tools from the Robert Wood Johnson Foundation for the health reform beat and AHCJ’s New York chapter recently got to hear about them in more detail with some help from RWJF. If you’ve done stories using this data, we’d love to see them and learn about how you used the data. Send them to email@example.com.
Kentucky, a southern state implementing the ACA, has gotten a fair amount of media attention and we’ve highlighted some of the coverage.
But, in impoverished rural areas that stood to gain the most from the greater access to care that the ACA promised, many residents remained fiercely opposed to the law and the president who pushed it.
Given the recent discussion on the AHCJ discussion list and elsewhere about the right balance between covering the politics of the Affordable Care Act versus the policy of the ACA, I thought it would be a great time to showcase a reporter who does both.
David Ramsey of the Arkansas Times has been all over the story of Arkansas’ “private option” Medicaid expansion. That’s definitely been a political story – Arkansas legislators have slugged it out for two sessions and it’s going to happen again next year, with the fate of Medicaid expansion always on the line. But Ramsey (@arkdavey) recently did a long and readable piece on the faces of Arkansas health care expansion. He matched the politics, the policy and the people. And he did more than present their faces. He captured their voices. Continue reading
Rural areas have a disproportionate need for primary care physicians but, according to a panel of physicians at Rural Health Journalism 2014, that need is not being met.
In fact, 44 percent of rural areas in the U.S. are experiencing a shortage of primary care practitioners, said Andrew Bazemore, M.D., M.P.H., director, Robert Graham Center for Policy Studies in Family Medicine and Primary Care, American Academy of Family Physicians.
This sobering statistic illustrates what Mark A. Richardson, M.D., MScB, M.B.A., dean, School of Medicine, Oregon Health & Science University, called “geographic maldistribution” — urban areas having more active doctors per 1,000 people than rural areas.
Bazemore emphasized the importance of primary care, noting that in comparison to 10 other developed nations, the U.S. ranked lowest in both primary care and health outcomes.
Richardson drove the point home with some sobering information on the state of primary care in the U.S.: While there are 249 patient care physicians for every 100,000 Americans, there are only 106,000 primary care physicians. Almost 27 percent of those providers are over age 60, so their numbers are only expected to drop in the coming years.
So how can rural primary care get a boost?
Insurers are preparing to announce their premium rates for 2015. To learn how insurers set rates, Families USA and Consumers Union (the policy and advocacy arm of Consumer Reports) will host a national conference call on Thursday at noon ET for health care journalists.
Premium rates will be one of the biggest stories of the year because so much depends on whether they will rise by double digits or stay at about 10 percent, as they have in recent years. If rates rise much above double digits, Republicans in congressional midterm races are likely to use that information against Democrats who support the Affordable Care Act. If rates are at 10 percent or below, Democrats may be able to fend off such criticism.
Last week, Kelly Kennedy reported in USA Today that health insurance premiums grew an average of 10 percent annually in the three years before the ACA was enacted. She cited a report (PDF) from The Commonwealth Fund, “Growth and Variability in Health Plan Premiums in the Individual Insurance Market Before the Affordable Care Act” that explained the recent history of insurance rate increases. Continue reading
Ideastream’s Sarah Jane Tribble took a look at how small businesses that voluntarily cover their workers could be in for some premium shocks.
She focused on Paul Siperke, co-owner of Fat Head’s, a Cleveland brew club. It’s a small business and, with fewer than 50 employees, there is no requirement to cover workers. But the owners do voluntarily.
And the costs keep rising – sometimes double digits, sometimes only as little as 3 percent.This year, Tribble reported, rates soared by 20 percent under the ACA, even though most of the workers are young and healthy.
She explains why: Continue reading