Category Archives: Hospitals

Reaching rural populations and providers: more from #ruralhealth15

Susan Heavey

About Susan Heavey

Susan Heavey, (@susanheavey) a Washington, D.C.-based journalist, is AHCJ’s topic leader on social determinants of health and curates related material at healthjournalism.org. She welcomes questions and suggestions on resources and tip sheets at susan@healthjournalism.org.

Medical student Russell Stanley (left) and Dr. Kevin Blanton (right) share the stresses and triumphs of providing care in rural settings at AHCJ’s June 19 Rural Health Workshop.

Photo: Pia Christensen/AHCJMedical student Russell Stanley (left) and Dr. Kevin Blanton (right) share the stresses and triumphs of providing care in rural settings at AHCJ’s June 19 Rural Health Journalism Workshop.

Distance dominated much of the conversation at AHCJ’s recent Rural Health Journalism Workshop in Fort Worth, Texas, a vast state with wide open spaces and far-flung cities.

While such expanses can offer a quiet alternative to urban areas, panelists at #ruralhealth15 also noted that such isolation can impact not only health, but education and other community resources. And that can present another challenge: attracting health professions to rural pockets to provide needed care for residents. Continue reading

Health care delivery reform and what it means in the delivery room

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.

Courtesy of Neel Shah, M.D.

Courtesy of Neel Shah, M.D.Health reformers are grappling with how to bring down the high rate of cesarean section deliveries in the United States. The U.S. isn’t the only country in the world overusing the procedure, but it does have one of the highest rates.

I recently heard Neel Shah, M.D., an obstetrician at Beth Israel Deaconess Medical Center, the founder of Costs of Care, and associate faculty at Ariadne Labs (more about all of that here) speak about health care quality and delivering babies.

We’ve all heard about unnecessary cesarean sections (and elective induced early births, although that’s a related but not identical set of challenges). Many of us tend to think of it as a doctor-centered issue. Some doctors perform more C-sections than others and there are a host of reasons, ranging from how and where they were trained to how they assess and tolerate maternal risk to time management and financial considerations.

But Shah challenged me to think of unnecessary C-sections as a hospital management or system engineering problem – not just a problem created by individual doctors. Continue reading

Another report casts skeptical eye on patient satisfaction surveys

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

After we posted in May on issues concerning hospital patient satisfaction surveys, the Hastings Center, a Garrison, N.Y., research institute focusing on bioethics, published its own skeptical report. The full text requires a purchase, but the abstract raises some of the same questions we addressed and brings up a few more.

“The current institutional focus on patient satisfaction and on surveys designed to assess this could eventually compromise the quality of health care while simultaneously raising its cost,” authors Alexandra Junewicz and Stuart Youngner write in Patient-Satisfaction Surveys on a Scale of 0 to 10: Improving Health Care, or Leading It Astray?

Their main worries: Continue reading

Workshop to offer look at nation’s rural health landscape #ruralhealth15

Susan Heavey

About Susan Heavey

Susan Heavey, (@susanheavey) a Washington, D.C.-based journalist, is AHCJ’s topic leader on social determinants of health and curates related material at healthjournalism.org. She welcomes questions and suggestions on resources and tip sheets at susan@healthjournalism.org.

A lot has been made of mapping health care lately, from states and counties to ZIP codes and income. But take a step back, and a lot of the issues facing health care writers and policymakers are part of the nation’s larger rural-urban divide.

The Association for Health Care Journalists is offering a chance on June 19 for health writers to explore what is happening in America’s less populated areas as well as the emerging trends at its Rural Health Journalism Workshop. Continue reading

For AHCJ members: Updated data about hospital charges to Medicare

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.

Image by Neff Conner via Flickr

Image: Neff Conner via Flickr

With an update from the Centers for Medicare & Medicaid Services data showing what hospitals across the country charge Medicare for the same treatment or procedure in 2013, AHCJ has updated its own version of the dataset that allows members to compare hospitals’ charges from one year to the next.

Last year, CMS released data files that include bills submitted by 3,500 hospitals for the 100 most commonly performed inpatient conditions in 2011 and 2012. The new release includes 2013. This allows a basis for some local or regional comparisons and a starting point for stories on hospital costs and services. Continue reading

Proposal would change how hospitals bill for services after acquiring physician groups

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 Truthout.org via flickr.

Photo by Truthout.org via flickr.

When health policy experts talk about ways to improve how Medicare and commercial health plans pay for care, they often recommend eliminating what’s called the site-of-service payment differential.

This differential allows hospitals to charge more than physicians can charge for doing the same service, in part because hospitals have more overhead.

For patients, the difference can affect whether a copayment is low if care is delivered in a doctor’s office or high if the service is done in a hospital. Continue reading

Journalists expose weaknesses in Idaho’s fragmented, threadbare mental health system

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.

Audrey Dutton

Audrey Dutton

Emilie-Ritter-Saunders.jpg

Emilie Ritter Saunders

Last fall, The Idaho Statesman newspaper and NPR member station Boise State Public Radio ran a series titled, “In Crisis,” that explored Idaho’s fragmented and underfunded mental health care system.

Statesman business reporter Audrey Dutton (@IDS_Audrey) and Emilie Ritter Saunders (@EmilieRSaunders), who was then the BSPR digital content coordinator, collaborated on the series. Both journalists produced stories for print, radio and online.

Dutton and Saunders found that Idaho’s threadbare mental health care system does not serve well the many Idahoans who need quality, timely and appropriate behavioral and mental health care.

Their work could serve as a blueprint for journalists covering this challenging story in any state. In the series, Dutton and Saunders reported that the state does not have enough psychiatrists or treatment facilities for the population they serve and that it doesn’t have enough mental health resources for the state’s poorest residents.

They also report that about 25 percent of the state’s residents are living with a mental illness, which is a bit higher than the national average of 20 percent. And, they found, Idaho has one of the highest suicide rates in the country, about 48 percent higher than the national rate.

As is common throughout the United States, Dutton and Saunders wrote that, in addition to leaving many Idahoans without proper care, the mental health system is so frayed that the police are often called when a patient suffers a mental health crisis and the state’s courts and jails are among the largest providers of mental health care. Sadly, they added, those with mental illness frequently are hospitalized because more appropriate settings for mental health care are unavailable. They also found that the state Medicaid program serves those in need inadequately.

Read more about how they did the reporting in this article for AHCJ members.

What that recent emergency department survey didn’t tell us

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.

emergency-roomEarlier this month many of us received a news release from the American College of Emergency Physicians about a survey that indicates emergency department visits are rising along with coverage expansion under the Affordable Care Act. This was happening even though one important goal of the health law is to connect people with primary care physicians so they wouldn’t feel compelled to go to the ED for primary care.

While many of us ignored the release or, at most, wrote a brief; some large news outlets did give the survey big play, even linking the increase to expanded Medicaid coverage. The tone of that coverage, at least in a few pieces I saw, was that this was a negative development. Continue reading

Illnesses, injuries linked to medical devices a ripe area for investigation #ahcj15

Paul Sisson

About Paul Sisson

Paul Sisson covers health care for U-T San Diego. He attended Health Journalism 2015 on an AHCJ-California Health Journalism Fellowship, which is supported by The California HealthCare Foundation.

CDC/ James ArcherAn outbreak of carbapenem-resistant enterobacteriaceae (CRE) was linked to dirty duodenoscopes.

CDC/ James ArcherAn outbreak of carbapenem-resistant enterobacteriaceae (CRE) was linked to dirty duodenoscopes.

Most medical devices marketed in the United States do not need formal approval from the U.S. Food and Drug Administration.

Members of a panel at Health Journalism 2015 on medical device coverage provided a variety of advice for reporters covering and of the implants, instruments and diagnostic tools common to the modern medical machine.

Moderator of the session was Chad Terhune, a Los Angeles Times reporter who recently found himself chasing an outbreak of carbapenem-resistant enterobacteriaceae (CRE) linked to dirty duodenoscopes. Contributing to the discussion were panelists USA Today investigative reporter Peter Eisler and Scott Lucas, associate director of accident and forensic investigation at the ECRI Institute. Continue reading

Journalists get guidance on navigating HIPAA rules #ahcj15

Sheila Hagar

About Sheila Hagar

Sheila Hagar (@ubsheilahagar) is a columnist, blogger and reporter for the Walla Walla (Wash.) Union-Bulletin newspaper. She attended Health Journalism 2015 as an AHCJ-Rural Health Journalism Fellow.

Pia Christensen/AHCJJan Emerson-Shea, vice president  of external affairs for the California Hospital Association, guides journalists in how to work with hospitals and patient privacy laws at Health Journalism 2015.

Pia Christensen/AHCJJan Emerson-Shea, vice president of external affairs for the California Hospital Association, guides journalists in how to work with hospitals and patient privacy laws at Health Journalism 2015.

The Health Insurance Portability and Accountability Act was enacted nearly 20 years ago to make reporters gnash their teeth. Not quite, presenters at Health Journalism 2015 in Santa Clara, Calif., told their audience.

HIPAA, as it was birthed into law in 1996, was intended to make it easier for people to keep their health insurance when they change jobs. The law set standards for the electronic exchange of patient information, including protecting the privacy of such records. The U.S. Department of Health and Human Services issued the Privacy Rule to implement that aspect of the law, and its Office of Civil Rights is in charge of enforcing it.

The Privacy Rule, which went into effect in April 2003, has made it more difficult for reporters to get information about individuals’ health care, such as the names and condition of accident victims. Hospital employees and reporters not well informed about the law make things even harder.

It is important to remember some key points about HIPAA and other patient privacy laws, presenters said: Continue reading