Category Archives: Public records

Judge’s decision puts Medicare data in public realm

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.

A decision announced Friday would allow the public and journalists access to Medicare claims data about individual doctors.

An injunction barring release of the data had been in place for 33 years, “when a federal court in Florida sided with the American Medical Association’s contention that doctors’ right to privacy trumped the public’s interest in knowing how tax dollars were spent,” according to John Carreyrou of The Wall Street Journal.

“Dow Jones & Co., The Wall Street Journal’s parent company, challenged the injunction in 2011 after the Journal published a series of articles showing how the information could be used to expose fraud and abuse in the $549 billion health-care program for the elderly and disabled.”

Wall Street Journal reporters, who negotiated for eight years worth of data if they did not publish identities, wrote a series of stories about Medicare data, showing that the federal government isn’t taking advantage of the data it has to detect fraud. The Wall Street Journal’s articles have offered a window into the forces driving up health spending and shown that analyzing the data can reveal abuse and fraud in the Medicare system.

“The public has a right to know how much physicians are being paid by Medicare and what services they are providing patients,” said AHCJ President Charles Ornstein. “With analysis and context from journalists, the data could help patients make informed decisions and provide necessary oversight of billions of dollars in federal spending.”

Carreyrou reports the American Medical Association “is considering its options on how best to continue to defend the personal privacy interests of all physicians.”

The Crushing Cost of Care,” by the WSJ’s Janet Adamy and Tom McGinty, won first place in the Health Policy (large) category of the 2012 Awards for Excellence in Health Care Journalism.

Read more about the Medicare data and the fight to open it to the public:

After 5-year FOIA fight, documents show ties between researchers, officials in Lyme wars

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.

Documents obtained after a long FOIA battle reveal “behind-the-scenes maneuvers and long-standing connections between the scientists’ group and government officials” in the debate over whether Lyme disease can be chronic.

The debate, and the fight for the documents, are detailed by Mary Beth Pfeiffer in the Poughkeepsie (N.Y.) Journal and by documentary film maker Kris Newby on IRE’s Transparency Watch blog.

In 2007, in doing research for a film, Newby requested emails and resumes pertaining to three employees at the Center for Disease Control and Prevention. She writes that “For five years the agency strung me along with frivolous denials, mysterious delays, shifting explanations and false promises. In essence, the delays became an illegal, off-the-books FOIA denial.” Her account of how the CDC handled – or didn’t handle  her request is alarming.

Newby, whose film had been completed, provided the 3,000 pages of documents to Pfeiffer.

The documents show close connections between the government officials who set disease policy and researchers who have received government funds and written treatment guidelines. “As a result, physicians and scientists with opposing views on Lyme disease believe they have been marginalized in the debate.” This graphic provides a good overview of the connections and issues.

CMS unveils dataset on top hospital discharge payments

Liz Seegert

About Liz Seegert

Liz Seegert (@lseegert), AHCJ’s topic leader on aging, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover the many issues around our aging society. If you have questions or suggestions for future resources on the topic, please send them to liz@healthjournalism.org.

The public can now compare hospital-specific charges for the top 100 most frequently billed discharges at the 3000+ hospitals across the US that receive Medicare payments.  The Center for Medicare and Medicaid Services unveiled its free Medicare provider charge dataset which can be analyzed down to ZIP code level.

Jonathan Blum, acting principal deputy administrator of CMS, said in a webinar with AHCJ members that this effort has been years in the making, as part of the agency’s effort to be more transparent.

Data for FY 2011 is on the AHCJ website, downloadable as an Excel file (a CSV file is available from CMS). From there, it can be sorted by diagnosis related group (DRG) codes, city, state, ZIP and charges. This tool allows journalists, advocates and consumers to compare costs nationally, between or among states, cities, or counties. Data is only available for Medicare Inpatient Prospective Payment System (IPPS) — the fee-for-service component — based on a rate per discharge using the Medicare Severity Diagnosis Related Group (MS-DRG). These DRGs represent almost 7 million discharges or 60 percent of total Medicare IPPS discharges. It does not include data for U.S. territories or Puerto Rico, or for any Medicare Advantage payments.

Chris Powers, acting director of the Information Products Group, Office of Information Products and Data Analytics demonstrated the dataset by comparing the varying cost of a total joint replacement. Selecting the specific DRG code netted charges ranging from $321,000 to just over $20,000.

The goal is to empower consumers, particularly those who are uninsured and may have to bear the entire cost, who may be underinsured, or who have a high deductible, to ask about appropriate charges  for a given procedure and question discrepancies that cannot be explained by geography, patient population, or affiliation differences. Medicare IPPS pays a fixed cost to hospitals, however, this data can be used as a guideline for non-Medicare fee-for-service charges.

In the Q&A section of the webinar, I asked if there would be a similar data set compiled for Medicare Advantage payments so consumers insured under those plans can also compare charges. Powers said CMS is looking at what the next steps are in terms of data release. “That is a very good question and certainly those concerns are in our minds as we make those considerations.”

Join today’s webinar on newly released hospital cost data

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.

The federal government released data today showing what hospitals across the country charge Medicare for the same treatment or procedure. The 2011 data includes bills submitted by 3,300 hospitals for the 100 most commonly performed treatments. This allows a basis for some local or regional comparisons and a starting point for stories on hospital costs. 

The data is available on the AHCJ website. A webinar for AHCJ members on using the data will take place today at 2 p.m. ET with Jonathan Blum, the acting principal deputy administrator at the Centers for Medicare & Medicaid Services, and Karl Stark, AHCJ vice president and Philadelphia Inquirer health editor. Register here.

More on medical costs

The cost of medicines, devices, tests and treatment is such an important element of health reporting that it is included in AHCJ’s Statement of Principles: “Strive to include information about cost and insurance coverage in any reporting of new ideas in medicine.”

Brenda Goodman, AHCJ’s topic leader on covering medical studies says that the runaway costs of such things are arguably one of the most important issues in medicine, but it’s one that’s often missing from health stories.

Michael Schroeder, who covers health for Angie’s List Magazine, is required to include meaningful medical pricing information in his stories. He acknowledges this is no simple task but urges reporters to have a strategy and be persistent. “You won’t always get the information you’re after, but your batting average will certainly go up, and you won’t be left to routinely settle for hollow numbers.”

To that end, Goodman and Schroeder have contributed tip sheets to help reporters get that vital information. Goodman focuses on several resources where you might find pricing information, while Schroeder shares his strategy and the specific questions he asks sources about costs.

Health Data WorkshopHealth Data Workshop

For more on using data to report on health care, journalists are invited to tap into health data in a special workshop, Oct. 3 & 4 in Anaheim, Calif.

This AHCJ workshop offers something for data newcomers and  veterans – from spreadsheet basics to visualizing data online. You’ll come away with skills and ideas on teasing stories out of datasets and tools on presenting these stories.

Pa. bill would require disclosure of food stamp purchases

Felice Freyer

About Felice Freyer

Felice J. Freyer is a member of AHCJ's board of directors, serving as co-chair of the organization's Right to Know Committee.

Food stamps

Photo by cosmocatalano via Flickr

A Pennsylvania congressman last week filed a bill that would require retailers to report which items are bought with food stamps.

The proposed “SNAP Transparency Act,” sponsored by Republican Rep. Tom Marino, would require the secretary of agriculture to establish a uniform reporting system under which retailers would track “the complete range, identities, sizes, quantities, and costs of particular food items” purchased with benefits from the Supplemental Nutrition Assistance Program, or food stamps.

If passed, the legislation could give journalists and advocates access to long-sought information about the food purchases of SNAP recipients, at a time of growing concern about their access to healthy foods and about obesity and related health problems among the poor. Currently the U.S. Department of Agriculture does not have the authority to collect such information.

The act would address one of two issues raised in a recent letter to Agriculture Sec. Tom Vilsack from AHCJ and six other organizations representing journalists and open-government advocates. Continue reading

Drugs remain on market despite fraudulent research; FDA withholds information

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.

Despite concluding that a drug research lab’s violations “were so ‘egregious,’ and pervasive that studies conducted there between April 2005 and August 2009 might be worthless,” the FDA didn’t pull the drugs tested there from the market, according to a ProPublica piece by Rob Garver and Charles Seife.

pills

Photo by Grumpy-Puddin via Flickr

The FDA is refusing to release information about those drugs, saying that “We believe that this did not rise to the level where the public should be notified.”

A statement from the agency said, “The issue is not a lack of transparency but rather the difficulty of explaining why the problems we identified at Cetero, which on their face would appear to be highly significant in terms of patient risk, fortunately were not.” Continue reading

Journalists call on USDA to release food stamp information

Felice J. Freyer & Irene Wielawski

About Felice J. Freyer & Irene Wielawski

Felice J. Freyer and Irene Wielawski are co-chairs of AHCJ's Right to Know Committee and members of AHCJ's board of directors.

The Association of Health Care Journalists, along with six other journalism and open-government groups, has called on the U.S. Department of Agriculture to release to the public vital information about the multibillion-dollar food stamps program.

Currently, the USDA refuses to reveal how much money individual retailers make from the Supplemental Nutrition Assistance Program, better known as food stamps. Additionally, the USDA does not disclose which products are purchased with SNAP dollars or how much is spent on each product, in aggregate.

This information could show which businesses benefit from the program and also inform public policy debates about obesity and its causes, the organization argues.

The USDA’s position runs contrary to President Obama’s promise of government transparency, and stands in sharp contrast with practices at other federal agencies. For example, the Temporary Assistance for Needy Families discloses where recipients used their EBT cards to withdraw cash assistance. A wealth of information is available about Medicare and Medicaid. Continue reading

Online hospital inspection reports open door to power reporting #ahcj13

Alan Scher Zagier

About Alan Scher Zagier

Alan Scher Zagier is a reporter at The Associated Press. He is attending Health Journalism 2013 on an AHCJ-Missouri Health Journalism Fellowship, which is supported by the Missouri Foundation for Health.

Any reporter who has sought public records from the feds knows the practical nightmare that is the Freedom of Information Act (FOIA).  Delays of months, years and even decades before receiving requested documents or data are not uncommon.

Now, after years of negotiations with the Centers for Medicare and Medicaid Services (CMS), the Association of Health Care Journalists is offering both reporters and the general public instant online access to thousands of federal inspection reports for hospitals nationwide with a searchable news application at hospitalinspections.org.

AHCJ board president Charles Ornstein of ProPublica helped unveil the site at a Saturday morning news briefing in Boston.

“Until now, you weren’t able to see what [hospitals] were doing, because you had to request all these in PDF format, and compare them [individually],” he said. “Now, you can actually use the power of data to find examples, and write that story. Continue reading

Panel will discuss newly released 990 data on hospitals #ahcj13

About Karl Stark

Karl Stark, vice president of AHCJ's board of directors, is the assistant managing editor, health and science, at The Philadelphia Inquirer.

AHCJ has just released a new trove of information from GuideStar on the finances of nonprofit U.S. hospitals. This information – from tax years 2009 and 2010 – contains carefully selected highlights from the hospital’s IRS 990 forms, which nonprofits must file to maintain their mostly tax-free status.

Reporters can use this AHCJ spreadsheet to get:

  • detailed salary info on top executives
  • the institution’s charity care and community benefit numbers
  • a hospital’s lobbying expenses
  • and the business relationships of board members, among other things.

This data will be discussed at the Health Journalism 2013 session, “Diving into documents: Using 990s and more to cover hospital finances,” on Sunday at 10:40 am. Howard Rivenson, senior lecturer on health management, Harvard School of Public Health, will join me to help demystify hospital finances.

The newest material from 2010 is here and here are last year’s data.

Roundtable gives journalists chance to share tips on open access #ahcj13

Blythe Bernhard

About Blythe Bernhard

Blythe Bernhard has reported on health and medicine for the St. Louis Post-Dispatch since 2007. She serves on AHCJ's Right to Know and Contest committees.

Do your sources ask for email interviews or quote approval? Are press relations officers listening in on your interviews? The Right to Know Committee will host a roundtable discussion at Health Journalism 2013 on Thursday, March 14, to share stories and offer advice about these issues and other barriers to open and straightforward newsgathering.

A look at some of the issues, sessions and ideas to keep in mind for those planning to attend Health Journalism 2013, the annual conference of the Association of Health Care Journalists.

Peggy Peck, editor of MedPage Today, and Irene Wielawski, an independent journalist and founder of AHCJ, will join me in moderating the discussion. As members of the Right to Know Committee, we are advocates for public information and open access to government officials and medical experts.

Reporters at MedPage Today do not allow their sources to approve quotes. The website alerts readers when interviews are conducted in the presence of a publicist. Peck will talk about her decisions on these issues and advise other editors looking to implement similar policies in their newsrooms. Continue reading