Category Archives: Hospitals

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

Why we still need human relationships in an era of digital medicine

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), is AHCJ’s topic editor on aging. Her work has appeared in Kaiser Health News, The Atlantic.com, New America Media, AARP.com, Practical Diabetology and Home Care Technology report. She is a senior fellow at the Center for Health, Media & Policy at Hunter College in New York City, and co-produces HealthStyles for WBAI-FM/Pacifica Radio.

Is computerized medicine all it’s cracked up to be? Or has it so dramatically eliminated the human factor that we risk doing more harm than good?

Photo: @CharlesOrnstein via Twitter

Photo: @CharlesOrnstein via Twitter

That was the premise of Wednesday’s AHCJ New York City chapter meeting with guest speaker Robert Wachter, M.D., professor and associate chair, department of medicine and director, division of hospital medicine, at the University of California, San Francisco. Wachter provided the backstory of his hospital’s switch from analog to digital systems, how this process has hurt peer and patient relationships – and very nearly killed a 12-year old boy.

Wachter said he was excited about the push for computerized medicine a decade ago. “We had this grand idea that they [computers] would solve everything.” However, he since has come to believe that was that although computers are transforming his profession, it isn’t always for the better. Continue reading

Study: Little evidence that integrating hospital, physician care improves quality or reduces costs

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" PINKÉ via Flickr

Photo: PINKÉ via Flickr

When health system executives tout the benefits of acquiring hospitals or physician groups, they often say the combined entity will benefit consumers and insurers by improving health care quality and reducing costs.

A case in point is a plan from Partners HealthCare in Boston to acquire Harbor Medical Associates, a 70-physician practice south of Boston. The goal of the acquisition is to improve patient care, coordinate care to boost patient outcomes and cut costs, reported The Boston Globe’s Priyanka Dayal McCluskey. Partners is the highest-cost health system in the state, she wrote.

In a post about the proposal in his blog, Not Running a Hospital, Paul Levy wrote that the acquisition would cause Harbor Medical doctors to steer patients to Partners’ hospitals. “So not only would local MD visits become more expensive: Follow-up secondary and tertiary care would also,” Levy wrote.

We know, of course, that acquisitions in health care are about making money, as Dan Goldberg wrote in this tip sheet and Joanne Kenen reiterated earlier this week.

Now, in a new report, researchers for the National Academy of Social Insurance, show there is little evidence that organizing hospital and physician care into integrated delivery networks (IDNs) has promoted quality or reduced costs. “Indeed, there is growing evidence that hospital-physician integration has raised physician costs, hospital prices and per capita medical care spending,” the report said. Continue reading

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.

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