Category Archives: Hospitals

Exploring ‘preventable harm’ and making it accessible to readers

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.

Sarah Kliff

Sarah Kliff

Vox’s Sarah Kliff, who has an AHCJ Reporting Fellowship on Health Care Performance, is writing a series about fatal, preventable medical errors.

Not the inevitable tragic things that can happen to a patient – but the ones that we know how to avoid, the lives that should not be at risk.  Kliff spent several months on one story – actually a story and accompanying video and graphics – that combined insights about how hospitals think central line infections and a gripping narrative about the death of a 3-year-old girl.  You can find the story here.

Kliff wrote a “How I did It” essay for AHCJ that addresses a lot of the nuts and bolts of a vast project like this. She outlines how she reached out to patients/families, how she organized the voluminous – initially not searchable – medical records, how she found researchers who could elucidate things she did not fully understand in those records.

And she talks about the power of a good analogy to both organize a 5000-word narrative and give readers an accessible entry point to her work. Read about how she did it.

Medicaid expansion shapes hospital financial health

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.

ccok-county-hospitalWe’ve all written a lot about the “Medicaid gap” – the low-income people who can’t get coverage under the Affordable Care Act because their states have opted out of Medicaid expansion. The Kaiser Family Foundation has estimated that 4 million people fall in this gap.

According to Moody’s Investors Service, nonprofit hospitals in expansion states have seen their bad debt from unpaid bills drop an average of 13 percent as they treated more patients who have coverage. In non-expansion states, bad debt rose.

Reuters’ Robin Respaut recently looked at how the Medicaid gap has affected two iconic urban safety net hospitals who treat a lot of low income people – Cook County in Chicago and Grady Memorial in Atlanta. Continue reading

Some hospitals slow to adopt new systems of care

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.

PhotoJoel Dinda via Flickr

Photo: Joel Dinda via Flickr

We’ve told you over and over again on this blog that the Affordable Care Act isn’t just about coverage. It’s also about changing how health care is delivered, moving away from fee-for-service to a more value- and quality-based system. Medicare is aiming to have half of its payments under alternative payment models by 2018.

That means hospitals have to change. But not all of them want to.

Fee-for-service is the preferred business model for many. Why should those hospitals want to go through considerable expense and upheaval to switch to a new system that demands more – and may well pay less? Continue reading

Spotlight on sepsis: Reporting on ‘dirty little hospital horror’

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.

Cheryl Clark

Cheryl Clark

As senior quality editor for HealthLeaders Media for more than six years, Cheryl Clark wrote more than 1,300 stories about hospitals’ efforts to improve quality and safety and related issues.

Rates of sepsis seemed to be one more dirty little hospital horror to explore, one that the Joint Commission said cost hospitals about $16.7 billion annually. Yet hospitals’ efforts to tackle it seemed hidden behind improvement initiatives attracting more attention, such as reducing hospital-acquired infections, and preventable readmissions, lowering emergency room wait times and raising patient experience scores.

The story she wrote for the June 2014 issue of HealthLeaders’ print magazine, on how U.S. hospitals are improving recognition and treatment of sepsis — which is diagnosed in 750,000 patients a year and kills 40 percent — won the 2015 National Institute of Health Care Management prize in the trade print category. They said the story was “most likely to save a life.”

In a new article for AHCJ, she explains how she did her reporting, despite a lack of data and sources who didn’t want to talk. Read more.

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