Category Archives: Hospitals

Hospital survey data updated, with changes

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.

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.

Early trends emerge following Medicaid expansion

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.

Image by Colin Dunn via flickr.

Image by Colin Dunn via flickr.

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

What happens when hospitals abandon inner cities

Joe Rojas-Burke

About Joe Rojas-Burke

Joe Rojas-Burke is AHCJ’s core topic leader on the social determinants of health. To help journalists broaden the frame of health coverage to include factors such as education, income, neighborhood and social network, Rojas-Burke will hunt for resources, highlight excellent work and moderate discussions with journalists and experts. Send questions or suggestions to joe@healthjournalism.org or tweet to @rojasburke.

Image by ken fager via flickr.

Image by ken fager via flickr.

Hospitals in the U.S. have been abandoning inner cities for years. By 2010, the number of urban hospitals still operating in 52 big cities had fallen to 426, down from 781 in 1970. Meanwhile, hundreds of medical centers built with cathedral-like grandeur have opened for business in affluent suburbs. A hard-hitting series produced by the Pittsburgh Post-Gazette and Milwaukee Journal Sentinel explains the consequences of this trend for people in neighborhoods where hospitals closed.

The series shows how most of the defunct hospitals were small to mid-size community hospitals and public hospitals that had served poor urban neighborhoods. The closures left many low-income neighborhoods without an effective safety net, undermined efforts to recruit doctors, and did away with high-wage jobs for local residents. An incredibly detailed interactive map allows readers to track where old hospitals have closed and new ones have opened in cities across the U.S. since 1991. Continue reading

Covering hospital ratings? Here’s one aspect consumers need you to report #ahcj14

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.

Photo: Pia ChristensenA Health Journalism 2014 panel about hospital rankings included (left to right) Evan Marks of Healthgrades, Marshall Allen of ProPublica and John Santa, M.D., of Consumer Reports.

If you were at Health Journalism 2014, you might have heard that things got interesting on Saturday when journalists questioned panelists who represented hospital ranking services about their business practices.

Tony Leys

Tony Leys, a reporter for the Des Moines Register, was in the audience for “Hospital grading: Reporting on quality report cards” and asked Evan Marks, the executive vice president of informatics and strategy for Healthgrades, how much hospitals pay his organization to be allowed to advertise their ratings. Marks refused to answer the question.

After the panel, Leys pursued the question and got some details that all reporters should be aware of when they consider writing about hospital rankings, including some concrete data on how much hospitals are paying in “licensing fees” to ratings services. You might use his technique to find out how much some of your local hospitals are paying.

Read this tip sheet to find out more.

Hospitals rethink charity for those passing on Obamacare

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.

columbiahospitalThe basic calculation uninsured people had to make this first open enrollment season in the ACA is whether to  get covered – or take the risks of going without health insurance and pay a penalty (unless they are exempt.)

After all, some of them probably figure, they have managed to get discounted or charity care in the past. Why should that change?

It might.

Some hospitals are pondering changes in their policies about how to treat the uninsured, according to an interesting article by Melanie Evans that appears in Modern Healthcare.

The changes they are thinking about won’t affect emergency care; under the Emergency Medical Treatment & Labor Act (EMTALA) hospitals have to stabilize someone coming in with an emergency. But it does affect what they may charge people for care, and how and when they provide non-urgent care.

Continue reading

Simulating an emergency room response #ahcj14

Hoag Levins

About Hoag Levins

Hoag Levins is managing editor for digital publications at the Leonard Davis Institute of Health Economics (LDI), a center within The Wharton School at the University of Pennsylvania.

Photo by Hoag Levins

Photo by Hoag Levins

Thursday’s field trip to the University of Colorado Anschutz Medical Campus included a visit to the School of Medicine’s health simulation facility, the Center for Advancing Professional Excellence. As part of that visit, AHCJ members were selected to try their hand at treating a computer-controlled dummy patient. This photo shows three of them in the simulation “emergency room” with a dummy industrial-accident patient. They are:

In the hard hat, Rachel Roubein, a health reporter at the Carroll County Times in Westminster, Md., is playing the role of “friend or family member” who delivered the patient to the ER and then became obnoxious, creating an added stress level under which medical personnel had to work.

Joey Failma, in the green scrubs, is a CAPE staffer playing the role of ER doctor.

Marijke Vroomen-Durning, in the middle, is – in real life –  a registered nurse and an independent journalist from Montreal, Quebec, playing the part of an ER nurse.

Margarita Cambest, in the white coat, is a staff reporter at the Kentucky New Era in Hopkinsville, Ky. She is acting as a nurse’ aide keeping pressure on a severely cut leg.

With control room computers changing the patient’s condition to dire, and the monitors showing his rapidly declining biometrics, the scene was a frantic, but educational, one. In the end the patient died and the AHCJ members left with a much better sense of both the importance of clinical simulators in the medical education process as well as the kind of often-excruciating stress ER clinicians must work in.

Cost reports show financial health of hospitals, amount of charity care they provide

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.

Clifton Adcock

Clifton Adcock

Oklahoma Watch, a nonprofit investigative journalism team, recently published a two-part series on hospitals based on financial data obtained for every hospital in the state. As reporter Clifton Adcock writes in an article for AHCJ, the series revealed that between half and three-fourths of small general hospitals in Oklahoma were losing money, and that hospitals had spent only small fractions of their net patient revenues on charity care.

Hospitals get “disproportionate-share” (DSH) payments from the federal government to help cover costs for treating the indigent. Because Oklahoma was not expanding Medicaid under the Affordable Care Act, hospital groups said they expected to take a big financial hit from the law’s cuts to DSH payments. Oklahoma Watch wanted to see how much they relied on such payments. Continue reading

What really happens if hospitals lose ‘critical access’ status?

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.

David Wahlberg

David Wahlberg

In rural areas, the federal Centers for Medicare & Medicaid Services designates more than 1,300 hospitals as being “critical access hospitals.” So designated, these facilities get a bit more in reimbursements to ensure that Americans outside of cities and suburbs can get the care they need without having to travel too far. In August, a report from the Office of Inspector General of the federal Department of Health and Human Services recommended that 80 percent of these facilities be decertified.

When he learned of the report, David Wahlberg, a health/medicine reporter for the Wisconsin State Journal, interviewed administrators at critical access hospitals in Wisconsin and found that the administrators believed closing these hospitals would have a detrimental effect on care for Medicare patients. Continue reading

Should journalists cover hospital ratings?

Charles Ornstein

About Charles Ornstein

Charles Ornstein is a senior reporter with ProPublica in New York. The Pulitzer Prize-winning writer is a member of the Association of Health Care Journalists' board of directors and past president.

(Editor’s note: This was originally published on Ornstein’s Tumblr site and re-published here with his permission.)

Few things in health journalism make me cringe more than news releases touting hospital ratings and awards. They’re everywhere. Along with the traditional U.S. News & World Report rankings, we now have scores and ratings from the Leapfrog Group, Consumers Union, HealthGrades, etc.

I typically urge reporters to avoid writing about them if they can. If their editors mandate it, I suggest they focus on data released by their state health department or on the federal Hospital Compare website. I also tell reporters to be sure to check whether a hospital has had recent violations/deficiencies identified during government inspections. That’s easy to do on the website hospitalinspections.org, run by the Association of Health Care Journalists (Disclosure: I was a driving force behind the site.)

Last week, I got an email from Cindy Uken, a diligent health reporter from the Billings (Mont.) Gazette. She was seeking my thoughts on covering hospital ratings. I sent her a story written by Jordan Rau of Kaiser Health News about the proliferation of ratings. Two of every three hospitals in Washington, D.C., Rau reported, had won an award of some kind from a major rating group or company. He pointed out how hospitals that were best-in-class in one award program were sometimes rated poorly in another.

This got me thinking: What should reporters tell their editors about hospital rankings, ratings and awards. I sought advice from Rau, ProPublica’s Marshall Allen, Steve Sternberg of U.S. News & World Report and John Santa of Consumers Union. Here’s what they told me: Continue reading

Hospital inspections website, data updated

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.

AHCJ has updated its hospitalInspections.org website and the downloadable version of the data to include reports through June.

Obtained from the Centers for Medicare and Medicaid Services, the database includes reports about deficiencies cited during complaint inspections at acute-care and critical access hospitals throughout the United States since Jan. 1, 2011. It does not include results of routine inspections or those of psychiatric hospitals or long-term care hospitals. It also does not include hospital responses to deficiencies cited during inspections.

The update added 919 records with inspection details, giving the database a total of 6,175 records. Some state health departments and CMS regional offices have lagged in uploading deficiency reports to the agency’s main database. CMS has identified the hospitals with missing reports, and they are labeled as such on hospitalinspections.org. CMS has committed to working with its regional offices and state counterparts to speed the uploading of inspection reports so that the public has access to this important information. The updated database includes 850 inspections lacking details.

AHCJ launched the free, searchable news application in March. The inspection reports have been configured by AHCJ to be easily searchable by keyword, city, state and hospital name. The website is open to anyone, but only AHCJ members have access to a downloadable version and additional resources to help users understand what is being reported and what is not. These caveats are important for putting the information into context.

Funding for the hospitalinspections.org project was provided by the Ethics and Excellence in Journalism Foundation.