Category Archives: Health care reform

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.

Under­standing, explaining primary issues of 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

With oral arguments in King v. Burwell scheduled for tomorrow, the Supreme Court will likely rule in late June.

The case challenges whether subsidies, in the form of tax credits, can go to people in states using the federal exchange, or only to those in the states running their own health insurance marketplaces.

After the state cases and 2012 National Federation of Independent Business case, it is the third case that poses an existential threat to the Affordable Care Act. (Hobby Lobby and other contraception-related cases wouldn’t unspool the structure of the whole ACA, only that aspect of women’s preventive health care.)

This case isn’t about whether the Affordable Care Act is constitutional. (The 2012 case was.) This is about interpreting the text, and whether the language of the law allows the subsidies in the federal exchange states.

Learn more about the landmark Supreme Court case in this new tip sheet.

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

Even with ACA, ‘insured’ doesn’t necessarily mean ‘accessible’

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.

water-wordle-transparencyElisabeth Rosenthal’s latest piece on the craziness of our health care pricing looks at affordability of health care for people covered by the Affordable Care Act.

For people purchasing insurance, premiums are only part of the cost, although they are what many consumers focus on when they choose a plan. There are also deductibles, co-pays, and different rules for in-network and out-of-network care. For people covered by ACA exchange plans, costs can mount, big time, and it can be very confusing for patients to figure out what they are being or will be charged. Continue reading

What a reporter learned following primary care residents

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’ve posted a new tip sheet and a new “How I did it” piece that may yield some story ideas for reporters.

In her “How I did it” essay, Karen Brown describes how she tracked a group of primary care residents for a year of their training – a year in which two of the three she chose to focus on ultimately decided not to go into primary care after all.

“Their decisions may have been disappointing for the field, but they did make for a more compelling story. I was able to use their personal dilemmas, unfolding in real time, to illustrate the crisis in primary care,” she writes. Brown had an AHCJ fellowship to do her project, but she gives advice on how to embark on a similar project  – without a fellowship – in your community.

In the tip sheet, Lola Butcher explains the 340B drug program, which requires pharmaceutical companies to sell discounted drugs to eligible health care organizations that serve a lot of poor people. The drugs are for outpatient use.

But the program has continued to grow, prompting questions about its cost and purpose. “Like all good controversies,” Butcher writes, “this one has enthusiastic advocates and wild-eyed opponents, and it’s easy to get snagged by the passion of the partisans.”

Both feature projects were funded with AHCJ Reporting Fellowships in Health Care Performance.