Caution in order when tackling newly released Medicare data

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.

AHCJ hosted a webcast about the CMS data, featuring several CMS officials and Charles Ornstein, a senior reporter at ProPublica and member of AHCJ’s board of directors.

The federal government is expected Wednesday to release data on the services provided by – and money paid to – 880,000 health professionals who take care of patients in the Medicare Part B program. For 35 years, this data has been off limits to the public – and now it will be publicly available for use by journalists, researchers and others.

While the data offers a huge array of stories, which could take weeks or months to report out, it also has some pitfalls. Here are six things to be aware of before you dig in:

Have a strategy for storing and opening the data. This data set is big. About 10 million rows, from what I hear. Because of that, you won’t be able to analyze it in Microsoft Excel and you might not be able to open it in Microsoft Access. You’ll want to upload it onto a data server and analyze it in a more powerful program such as SQL or SPSS. This could well serve as a barrier to entry for smaller news organizations. You may want to partner with an academic institution or another news outlet to analyze the data. Continue reading

Lack of access to dental care leads to expensive emergency room care

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 healthjournalism.org. She welcomes questions and suggestions on oral health resources at mary@healthjournalism.org.

In recent years, hospital emergency departments (EDs) have drawn millions of poor and underinsured patients coping with dental problems. Yet EDs remain tremendously expensive and ineffective sources of dental care, two new studies remind us.

Between 2008 and 2010, more than 4 million patients turned to hospital EDs for help with dental conditions at a cost of $2.7 billion. Research suggests that the vast majority did not receive dental procedures, but were instead treated with prescription medications. A total of 101 of the patients died in the emergency rooms, according to the study published in the April issue of the Journal of the American Dental Association.

The authors used data gleaned from the Nationwide Emergency Department Sample of the Healthcare Cost and Utilization Project, sponsored by the Agency for Healthcare Research and Quality (AHRQ), to produce their paper. They found that uninsured patients made slightly more than 40 percent of all dental-condition related ED visits. Continue reading

Using data from exchanges, journalists report on the true cost of health insurance

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.

When the federal and state exchanges opened for business on Oct. 1, 2013, health care journalists found a trove of stories worth reporting on the cost of health insurance.

But they also found that simply reporting on the premiums that consumers paid was only part of the story. Consumers also had to pay deductibles at each metal level (bronze, silver, gold and platinum) and these payments varied widely.

Reporters also found that the federal subsidies for the poor added a layer of complexity to their reporting that made covering the actual cost of health insurance to be difficult and confusing. Continue reading

For freelancers, ‘Contracts 101′ was important session at #ahcj14

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: Pia ChristensenHeather Boerner (left) moderated a panel that included freelance science writer and editor Kendall Powell (middle) and independent journalist Greg Smith.

Photo: Pia ChristensenHeather Boerner (left) moderated a panel that included freelance science writer and editor Kendall Powell (middle) and independent journalist Greg Smith.

Almost every freelancer has a horror story or two about contract negotiations gone awry. To help freelancers avoid the most common pitfalls when negotiating contracts, Health Journalism 2014 included a session titled Contracts 101. This session was important for independent health care journalists concerned about the business side of freelancing. Among the topics covered were the dreaded indemnity clauses, liability exposure, and how to estimate fees accurately.

Contracts 101 featured two freelancers (Kendall Powell, a science writer and editor, from Lafayette, Colo.; and Greg Smith, a photojournalist from Westcliffe, Colo.) and a lawyer in private practice, James Gregorio of Greensboro, N.C. Heather Boerner, an independent journalist from San Francisco, was the moderator. Cheryl Platzman Weinstock, a freelance writer in Connecticut, organized the panel but was unable to attend the conference.

Each speaker offered excellent advice on how freelancers can avoid the problems inherent in contract negotiations and what to do when publishers insert indemnity clauses in contracts. When they include these clauses, they often say, “Take it or leave it.” Whenever possible, Smith suggested freelancers should use their own contracts rather than settle for whatever publishers offer. Publishers draft contracts to suit their needs and rarely consider the needs of freelance writers, he said. Continue reading

New models bridge the gap in health care news #ahcj14

Andrea King Collier

About Andrea King Collier

Andrea King Collier is an independent journalist in Lansing, Mich. She is attending Health Journalism 2014 on an AHCJ-Ethnic Media Health Journalism Fellowship, which is supported by the Leona M. & Harry B. Helmsley Charitable Trust.

Necessity has become the mother of innovative business models for local news. It’s no secret that vanishing news outlets and shrinking staff at the outlets are causing a void in solid investigative reporting, that can be expensive and labor intensive to produce. Entrepreneurial journalists who are passionate about news have taken on the challenge with online news enterprises at the local, state and national levels.

At Health Journalism 2014 in Denver, Laura Frank, the executive director of I-News at Rocky Mountain PBS; Carol Gentry, editor of Health News Florida; Tim Griggs, a fellow at The Texas Tribune; Rosemary Hoban, editor of North Carolina Health News; and moderator Andy Miller, the editor of Georgia Health News; talked about the opportunities and challenges of creating new models for doing the deep dive into covering health news.

Gentry said the goal at Health News Florida is to fill the gap in coverage that went by the wayside. The site, which launched in 2007, “works hard to provide small investigations, but we don’t do anything that duplicates what is already being done out there,” Gentry said. “We only work to fill in the gaps in coverage, and we break news.”

Continue reading

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 and student members to AHCJ. All new members are welcome to stop by this post’s comment section to introduce themselves.

  • Colleen Gardephe, editor, MedShadow, New Rochelle, N.Y.
  • Brittney Haynes, independent journalist, Atlanta,
  • Ann Imse, editor, Colorado Public News, Morrison, Colo.
  • Caitlin Schmidt, student apprentice/reporter, University of Arizona/Arizona Daily Star, Tucson, Ariz.

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.

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.

Survey: Older patients like, want medical homes

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, Home Care Technology report and on HealthStyles Radio (WBAI-FM, NYC). She is a senior fellow at the Center for Health, Media & Policy at Hunter College, NYC, and a co-produces HealthStyles for WBAI-FM/Pacifica Radio.

Image by homesower via flickr.

Image by homesower via flickr.

Older patients like the kind of team care delivered in medical homes and most of those who get this care say it is actually improving their health, according to a new survey released today by the John A. Hartford Foundation. A representative sample of 1,107 adults aged 65 and older were asked about their experiences with patient-centered medical homes show that relatively few patients receive team care but more want it; and those who have experience with it like it and believe it improves health status.

Even among older adults not receiving this type of care, 61 percent say they believe team care would improve their health, and 73 percent would want this type of care, the survey found.

“The weakness of care coordination in our health care system represents a clear and present danger to many older patients, causing avoidable harm, errors, complications, overtreatment, and hospital readmissions,” said Christopher Langston, Ph.D., program director of the John A. Hartford Foundation. Continue reading

Getting the dirt on the allergy epidemic #ahcj14

Sandra Jordan

About Sandra Jordan

Sandra Jordan is a health reporter at the St. Louis American. She attended Health Journalism 2014 as an AHCJ-Ethnic Media Health Journalism Fellow, a program supported by the Leona M. & Harry B. Helmsley Charitable Trust.

Erwin Gelfand, M.D., chair of pediatrics at National Jewish Health, talks about environmental and behavioral factors behind allergies

Photo: Pia Christensen Erwin Gelfand, M.D., chair of pediatrics at National Jewish Health, talks about environmental and behavioral factors behind allergies

Are there more people with allergies, allergic responses, asthma and eczema than in years past? Is the environment the blame? The short answer is yes and yes.  However, there are other factors involved.

The panel discussion at Health Journalism 2014, “The Dirt on the Allergy Epidemic,” focused on causes and prevention of eczema, asthma and food allergies in children.

Since allergies were not prevalent 60 years ago, Erwin Gelfand, M.D., chair of pediatrics at National Jewish Health, said the difference points to environmental and behavioral factors.

“There is no doubt that the incidence of allergic diseases has increased and it can almost be traced five to six decades ago,” Gelfand said. “And the big question is; what changed that allowed this to go on?” Continue reading

Concerns over ‘fracking’ prompt research into health effects, occupational hazards #ahcj14

Tina Casagrand

About Tina Casagrand

Tina Casagrand is a freelance journalist in Jefferson City, Mo. She focused on investigative and environmental reporting at the Missouri School of Journalism and is a fellow at The Open Notebook. She attended Health Journalism 2014 as an AHCJ-Missouri Health Journalism Fellow, a program supported by the Missouri Foundation for Health.

Lee S. Newman, an environmental and occupational health physician of the Colorado School of Public Health, talks about the occupational hazards of fracking workers.

Photo: Tina Casagrand Lee S. Newman, an environmental and occupational health physician of the Colorado School of Public Health, talks about the occupational hazards of fracking workers.

Although 15 million Americans are now living less than a mile from natural gas wells, the research to evaluate any health hazards are thin.

Hydraulic fracturing, or fracking, is the process of drilling into the earth and injecting water, chemicals and sand to release natural gas. The extensive use of fracking has revived the energy industry in U.S., but the practice has prompted environmental and public health concerns.

For instance, carcinogenic chemicals, such as benzene, may escape and contaminate the groundwater around the fracking site and emit toxic substances into the air, said Cara DeGette, editor of Colorado Public News and moderator of the “Fracking, drilling, and other environmental health concerns” panel at Health Journalism 2014. Continue reading