This article originally appeared on ProPublica’s website.
The government’s new website on drug and device company ties to doctors will be incomplete and may be misleading – for now.
The government’s release today of a trove of data detailing drug and device companies’ payments to doctors has been widely hailed as a milestone for transparency. But it is also something else: a very limited window into the billions in industry spending. Before you dive in and search for a specific doctor, here are five caveats to keep in mind: Continue reading
One factor that makes health care costs difficult to manage is the system the federal government and health insurers use to decide how to pay physicians for the various services they deliver.
In an article in The Washington Post, “How a secretive panel uses data that distorts doctors pay,” journalists Peter Whoriskey and Dan Keating explain that a committee of the American Medical Association meets in private every year to develop values for most of the services doctors perform. The AMA is the chief lobbying group for doctors.
Read more about this secretive panel and the problems that Keating and Whoriskey identified wtih the process.
The Accreditation Council for Graduate Medical Education has rejected a request from AHCJ to publicly release additional information about the successes and failures of physician training programs nationwide.
Earlier this month, AHCJ called upon ACGME to release details about residency programs with less than full accreditation, as well as the rates at which graduates of residency programs pass their board certification examinations. ACGME posts decisions on favorable or less-than-favorable accreditation status but not the reasons for them.
Replying to AHCJ’s Aug. 5 letter, ACGME executive director Thomas J. Nasca, M.D., wrote that the organization would not provide the requested information, citing the confidentiality of ACGME’s review and decision process.
AHCJ president Karl Stark said he was disappointed by ACGME’s response. Continue reading
AHCJ’s latest update to nursing home inspection data gives members three years of the most severe deficiencies found during inspections and the current star ratings assigned by the U.S. Centers for Medicare and Medicaid Services.
The data could be a good starting point for reporters who want to pursue authoritative stories about their local nursing homes.
The data now contains 16,806 such deficiencies as recorded by CMS. Deficiencies are characterized by their severity, “A” being the least severe and “L” being the most severe. AHCJ pruned down the data to include just the most severe of the deficiencies, letters “G” through “L.” These range from an “isolated incident of actual harm” to “widespread immediate jeopardy to resident health or safety.”
Under its star rating system, CMS gives nursing homes between one and five stars. According to the CMS ratings web site “nursing homes with 5 stars are considered to have much above average quality and nursing homes with 1 star are considered to have quality much below average.” Each nursing home is given an overall rating, as well as three specific ratings: health inspections, staffing and quality measures.
The AHCJ version of nursing home data is derived from a large file that is split up for easier use by members.
AHCJ just added 3,522 detailed records of hospital deficiencies on its HospitalInspections.org website. The latest addition includes inspections into June.
The searchable site includes 12,674 different deficiencies among 2,055 hospitals in the United States. The data comes from the Centers for Medicare and Medicaid Services, part of the U.S. Department of Health and Human Services.
In addition, the site includes records showing that 492 hospital inspection reports have yet to be added to the CMS computer system.
The website includes the results of government inspections of acute-care hospitals, critical-access (rural) hospitals and psychiatric hospitals resulting from complaints. It does not include reports of deficiencies found at long-term care hospitals, nor does it include the results of routine hospital inspections.
The site offers inspections since Jan. 1, 2011, searchable by keyword, city, state and hospital name. The website is open to anyone. AHCJ members can also download the latest data to perform their own searches and analysis.
HospitalInspections.org was launched in March 2013 following years of advocacy by AHCJ urging the government to release the deficiency reports in an electronic format. Until then, reporters and the public had to file Freedom of Information Act (FOIA) requests with CMS to obtain the documents, a process fraught with delays. A December 2013 update added data on psychiatric hospitals.
The site is public but AHCJ members get the added bonus of being able to download the entire dataset and also get access to resources and tip sheets about how to best use the data in their reporting.
Measured by rates of violent death, the most dangerous counties in the United States have rates that are more than 10 times higher than the safest counties.
As you can see in the map below, rates vary from less than 10 to more than 100 violent deaths per 100,000 population, based on homicides, police shootings, and suicides in the years 2004 through 2010. (Counties with rates based on 20 or fewer deaths are unreliable and are marked as suppressed.)
I generated this map and the others below using WISQARS (Web-based Injury Statistics Query and Reporting System), an interactive database system that provides customized reports of injury-related data collected by the Centers for Disease Control and Prevention. The mapping module draws on seven years of data, the amount needed to produce reliable county-level injury-related death rates, according to the CDC, and it is a powerful tool to explore health disparities. Continue reading
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.
Here’s a resource for health care costs – and a creative journalistic model of crowdsourcing, data collection, mapping, reporting and blogging.
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
Last week, I encountered yet another example of why it’s so important to always read the whole study — not just the press release. In this case, it was actually a report, not a study. A press release from Alzheimer’s International with the somewhat misleading headline, “Smoking Increases Risk Of Dementia” arrived in my inbox, citing a new World Health Organization report that put smokers at a 45% higher risk for developing the disease than non-smokers.
When I opened the report, I learned that the “news” touted in the press release was actually just a summary of old research. There was nothing new here. Nor was there proof of causation – the cited evidence showed associations.
As I looked more closely at the report, I found an error that appeared to undermine its conclusions and suggest a sloppiness and lack of rigor.
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.
Charles Ornstein Storyfied the meeting and we have this guide for you from RWJF. Continue reading