New key concept: The inequality of violent injury and death

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 or tweet to @rojasburke.

The statistics are hard to believe.

  • The most dangerous counties in the United States have rates of violent death that are more than 10 times higher than the safest counties.
  • In Los Angeles County, homicide subtracts nearly five years from the expected life span of African American men in some neighborhoods.
  • Across the U.S., death by homicide is more than eight times more common among blacks, and three times more common among Native Americans, compared with white Americans.

What could account for such staggering inequalities? A new key concept in AHCJ’s core topic area on the social determinants of health sizes up the problem, what’s known about root causes, and how people are trying to reduce the unequal burden of violent injury and death.

Note how the risk of violent injury rose with each step of decreasing neighborhood socioeconomic status in this 10-year study of hospitalizations in Memphis, Tenn, and surrounding Shelby County.

How to understand 2015 exchange plan insurance rate changes

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 She welcomes questions and suggestions on health reform resources and tip sheets at

Image by 401(K) 2012 via Flickr

Image by 401(K) 2012 via Flickr

It’s rate increase season, and as we head into the second ACA enrollment season, it’s hard to understand why some rates are going up, some down – sometimes in the same place.

Also, some of the rates we’re hearing about are proposals. Depending on how much regulatory oomph state insurance officials have, the rates may change.

This post give you some ideas on what to watch for and how to think about rate increases in individual states, and what questions to ask the health plans and the regulators in your state. Remember that even in states using the federal exchange,, state insurance officials still have a role.

The Alliance for Health Reform (an invaluable resource on this issue) recently held a briefing on rate changes. The full briefing (webcast, transcript, background materials, source list) can be found online here.  A recent Health Affairs blog post by Christopher Koller and Sabrina Corlette provides another important resource.

Here are some key points outlined in these two resources: Continue reading

Are medical, dental boards public or private? Case over teeth-whitening services may decide

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health, curating related material at She welcomes questions and suggestions on oral health resources at

Image by waldopepper via Flickr

Image by waldopepper via Flickr

A long-simmering feud between North Carolina’s state dental board and a group of non-dentists who provide teeth-whitening services in malls and day spas is headed for the U.S. Supreme Court. Oral arguments in the case, North Carolina Board of Dental Examiners v. Federal Trade Commission, are scheduled for Oct. 14, the ADA (American Dental Association) News reports.

The decision could have wider implications for teeth-whitening shops – and for the dental and medical boards that regulate the health professions nationwide. Dental whitening has grown into a big business in recent years and, in a number of states, dental boards have taken steps to make the services illegal for anyone but dentists or hygienists to perform. Campbell Robertson provided a thorough look at the topic in a story last year for The New York Times.

In North Carolina, the Federal Trade Commission (FTC) has taken the side of the retail teeth-whitening shops. In 2011, the commission held that North Carolina’s state dental board “illegally thwarted competition by working to bar non-dentist providers of teeth whitening goods and services from selling their products to consumers.”

Last year, the U.S. Court of Appeals for the Fourth Circuit upheld the FTC’s ruling.

But the North Carolina dental board argues that its actions are not subject to such challenges because federal antitrust laws do not apply to actions taken by a state or its agencies. Continue reading

AHCJ pushes for more data on residency programs

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.

The Association of Health Care Journalists has called upon the accreditor of physician residency programs to be more transparent with its data so the public can be better informed about the quality of graduate medical education programs in their communities.

In a letter sent last week to the Accreditation Council for Graduate Medical Education, AHCJ praised the group for having a website that includes accreditation decisions for institutions and their individual training programs.

Karl Stark

Karl Stark

But it called on ACGME to do publish additional information, echoing a similar call by an Institute of Medicine panel for greater transparency in graduate medical education.

“We believe ACGME can play an even greater leadership role by providing additional information or advocating for its release,” said the letter, signed by AHCJ president Karl Stark. “Doing so would be in keeping with the new Institute of Medicine report, which called for ‘transparency and accountability of GME programs.’” Continue reading

Webcast: Under value-based insurance design, would insurers pay members for high-value services?

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


Thursday, Aug. 14, 1 p.m. ET

Here’s the bare-minimum definition of value-based insurance design: Those who are the most ill should pay the least for treatment.

The concept of VBID is a bit more complex, of course, but at its core, VBID would let those who would benefit the most from medications and other health care services pay the lowest in copayments and deductibles. In other words, there would be low or no financial barriers to the care these patients need.

Now let’s take the idea one step further. If some medications and medical services are so clearly beneficial that the insured would benefit to the point where savings would result, then should health insurers consider paying members to take some medications? And, should insurers also pay members to get certain high-value services?

On Thursday, A. Mark Fendrick, M.D., the director of the Center for Value-Based Insurance Design at the University of Michigan, will explain VBID in detail and address this somewhat startling possibility. In particular, he will discuss why health insurers should adopt VBID and why members of Congress in HR 5138 (pdf) are urging the federal Centers for Medicare & Medicaid to evaluate the effects of VBID for Medicare Advantage members.

Fendrick will be our guest for a webcast on VBID from 1 to 1:30 pm. Members are invited to participate and submit questions. Continue reading

Searchable hospital data now includes June inspections

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 just added 3,522 detailed records of hospital deficiencies on its website. The latest addition includes inspections into June.

The searchable site includes 12,674 different deficiencies among 2,055 hospitals in the United States. The data comes from the Centers for Medicare and Medicaid Services, part of the U.S. Department of Health and Human Services.

In addition, the site includes records showing that 492 hospital inspection reports have yet to be added to the CMS computer system.

The website includes the results of government inspections of acute-care hospitals, critical-access (rural) hospitals and psychiatric hospitals resulting from complaints. It does not include reports of deficiencies found at long-term care hospitals, nor does it include the results of  routine hospital inspections.

The site offers inspections since Jan. 1, 2011, searchable by keyword, city, state and hospital name. The website is open to anyone. AHCJ members can also download the latest data to perform their own searches and analysis. was launched in March 2013 following years of advocacy by AHCJ urging the government to release the deficiency reports in an electronic format. Until then, reporters and the public had to file Freedom of Information Act (FOIA) requests with CMS to obtain the documents, a process fraught with delays. A December 2013 update added data on psychiatric hospitals.

The site is public but AHCJ members get the added bonus of being able to download the entire dataset and also get access to resources and tip sheets about how to best use the data in their reporting.

Welcome AHCJ’s newest members

Len Bruzzese

About Len Bruzzese

Len Bruzzese is the executive director of AHCJ and its Center for Excellence in Health Care Journalism. He also is an associate professor at the Missouri School of Journalism and serves on the executive committee of the Council of National Journalism Organizations.

Please welcome these new professional members to AHCJ. All new members are welcome to stop by this post’s comment section to introduce themselves.

  • Renee Bacher, independent journalist, Baton Rouge, La. (@reneebacher)
  • Jean Buchanan, assistant managing editor/projects, St. Louis Post-Dispatch, St. Louis, Mo. (@JABuchanan)
  • Karisa King, reporter, Chicago Tribune, Chicago (@karisaking)
  • Patrick Malone, reporter, The Santa Fe New Mexican, Santa Fe, N.M. (@pmalonenm)

If you haven’t joined yet, see what member benefits you’re missing out on: Access to more than 50 journals and databases, tip sheets and articles from your colleagues on how they’ve reported stories, conferences, workshops, online training, reporting guides and more. Join AHCJ today to get a wealth of support and tools to help you.


Six (or more) things to remember when reporting on health care costs

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of, coordinates social media efforts of AHCJ and assists with the editing and production of association guides, programs and newsletters.

health-care-costs-reportersHealth care costs lack transparency and are wildly variable, not just from region to region but sometimes from block to block within the same city.

It is a complex topic, with chargemaster prices, what insurers paid and what consumers pay (if anything). Then there are the administrative rules set by Medicare and Medicaid and the negotiated rates between insurers and providers.

It’s daunting, but Lisa Aliferis of KQED, Rebecca Plevin of SCPR and Jeanne Pinderof have teamed up to offer guidance for reporting on health care costs in this new AHCJ tip sheet.

Fraud, marketing just part of problems with hospice system

Paul Kleyman

About Paul Kleyman

Paul Kleyman is director, ethnic elders newsbeat, for New America Media and the national coordinator of the Journalists Network on Generations, a group of 1,000 journalists who cover issues in aging.

Photo by Richard White via Flicker

Photo by Richard White via Flicker

A Huffington Post exposé in June, “Hospice, Inc.,” rekindled some thoughts I’ve long had about the split personality of the journalism on complex topics like aging.

One week, readers see richly reported news features, usually by health care or feature reporters, about the struggle of elders and their families caught in this country’s messy long-term care system. The next, readers get stories by political, economics reporters on bipartisan budget debates (how much to cut this year) or exposés that aim for accountability, but don’t help most families.

The Huffington Post project got me thinking – what’s the responsibility of an investigative team posting an approximately 7,000-word, six-month investigation? How can they get beyond house-of-horrors revelations? Continue reading

Missing context in reports on diabetic amputations

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 or tweet to @rojasburke.

Photo by Victor via Flickr

Photo by Victor via Flickr

People with diabetes in the lowest income neighborhoods of California were 10 times more likely to lose lower extremities to amputation than people with diabetes in the highest income neighborhoods, according to a new paper published in Health Affairs.

Many news outlets covered the story, but none that I read provided much context beyond repeating what the Health Affairs paper had to say, which is a shame because there’s a lot to report. Most ignored the disturbing racial disparity in amputation rates. (HealthDay News did note the study’s finding that less than 6 percent of diabetics in California are black, but they account for about 13 percent of amputations.)

The study authors mapped hot spots of diabetic amputation in Los Angeles and across California, where rates varied from less than one to more than 10 amputations per 1,000 people age 45 and older with diabetes in 2009. Continue reading