Tag Archives: medicaid

Journalists expose weaknesses in Idaho’s fragmented, threadbare mental health system

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.

Audrey Dutton

Audrey Dutton

Emilie-Ritter-Saunders.jpg

Emilie Ritter Saunders

Last fall, The Idaho Statesman newspaper and NPR member station Boise State Public Radio ran a series titled, “In Crisis,” that explored Idaho’s fragmented and underfunded mental health care system.

Statesman business reporter Audrey Dutton (@IDS_Audrey) and Emilie Ritter Saunders (@EmilieRSaunders), who was then the BSPR digital content coordinator, collaborated on the series. Both journalists produced stories for print, radio and online.

Dutton and Saunders found that Idaho’s threadbare mental health care system does not serve well the many Idahoans who need quality, timely and appropriate behavioral and mental health care.

Their work could serve as a blueprint for journalists covering this challenging story in any state. In the series, Dutton and Saunders reported that the state does not have enough psychiatrists or treatment facilities for the population they serve and that it doesn’t have enough mental health resources for the state’s poorest residents.

They also report that about 25 percent of the state’s residents are living with a mental illness, which is a bit higher than the national average of 20 percent. And, they found, Idaho has one of the highest suicide rates in the country, about 48 percent higher than the national rate.

As is common throughout the United States, Dutton and Saunders wrote that, in addition to leaving many Idahoans without proper care, the mental health system is so frayed that the police are often called when a patient suffers a mental health crisis and the state’s courts and jails are among the largest providers of mental health care. Sadly, they added, those with mental illness frequently are hospitalized because more appropriate settings for mental health care are unavailable. They also found that the state Medicaid program serves those in need inadequately.

Read more about how they did the reporting in this article for AHCJ members.

What that recent emergency department survey didn’t tell us

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.

emergency-roomEarlier this month many of us received a news release from the American College of Emergency Physicians about a survey that indicates emergency department visits are rising along with coverage expansion under the Affordable Care Act. This was happening even though one important goal of the health law is to connect people with primary care physicians so they wouldn’t feel compelled to go to the ED for primary care.

While many of us ignored the release or, at most, wrote a brief; some large news outlets did give the survey big play, even linking the increase to expanded Medicaid coverage. The tone of that coverage, at least in a few pieces I saw, was that this was a negative development. Continue reading

Reporters offer state, local story ideas for covering ACA #ahcj15

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.

The first day of Health Journalism 2015 featured a session “The ACA: Will it survive? And how to cover it now” with Kaiser Health News’s Julie Appleby and Vox’s Sarah Kliff. Their major themes included:

Julie Appleby & Sarah Kliff

Julie Appleby & Sarah Kliff

  • The King v. Burwell Supreme Court case over federal subsidies
  • What’s next in Congress?
  • Exchanges
  • Medicaid
  • And – the topic that got by far the most attention from the crowd – narrow networks.

Here are some of their highlights and story suggestions, with an emphasis on stories that state and local reporters can tackle. (Here are Kliff’s slides.) Continue reading

Maintaining Medicaid ‘bump’ a state-by-state endeavor

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.

Medicaid pay rates for doctors in many states traditionally have been extremely low – so low that most physicians didn’t want to participate in the program, or take on more Medicaid patients than they already had.

Joe Moser

According to the Kaiser Family Foundation, Medicaid had paid only 59 percent of what Medicare did for primary care before that.

The Affordable Care Act raised the rates for primary care providers to be equal to Medicare pay. Medicaid had paid only 59 percent of what Medicare did for primary care before that, according to the Kaiser Family Foundation. The snag: the Medicaid “bump” lasted for only two years, until the end of 2014. And Congress has not renewed it, although there has been a bit of preliminary talk about it. Continue reading

Personal story illustrates multiple barriers to health care, need for navigators

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.

Image by FutUndBeidl via Flickr

Image by FutUndBeidl via Flickr

Elizabeth Piatt begins the narrative of her reluctant journey into the Medicaid dental care system this way:

“In the spring of 2010 a terribly infected tooth forced my sister, Veronika, to the emergency department (ED). This story began, however, several months before. It is flica story of Medicaid, access to the best care, information and misinformation, and the gap between the haves and the have-nots.”

Piatt’s piece, “Navigating Veronica: How Access, Knowledge and Attitudes Shaped My Sister’s Care” was featured in February’s Health Affairs. (AHCJ members have free access to Health Affairs.)

Piatt, an assistant professor and chair of the Sociology Department at Hiram College in Hiram Ohio, brings a social scientist’s eye and a story-teller’s flair to the tale. Continue reading

In global struggle to care for aging populations, plenty of room for improvement

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 and Home Care Technology report. She is a senior fellow at the Center for Health, Media & Policy at Hunter College in New York City, and co-produces HealthStyles for WBAI-FM/Pacifica Radio.

Photo: Chester Paul Sgroi via Flickr

Photo: Chester Paul Sgroi via Flickr

Compared with other industrialized nations, patients age 65 or older in the U.S. are generally in poorer overall health and have more challenges paying out-of-pocket expenses than their counterparts in other industrialized nations, according to a new study in the November 2014 issue of Health Affairs. (Remember, AHCJ members get free access to Health Affairs.)

Older adults in 11 nations – Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States – were asked by telephone about their health and health care delivery. Among the 15,617 adults, age 65 or older, who participated in the 2014 Commonwealth Fund International Health Policy Survey of Older Adults, 20 percent of respondents in every country except France reported problems with care coordination. Access to primary care was most challenging in Canada, the U.S., and Sweden. Continue reading

Reporter shares experience covering Medicaid’s orthodontic benefits

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.

Sheila Hagar

Sheila Hagar

After a hint from her own dentist, Sheila Hagar started looking into concerns about the rising numbers of Medicaid kids getting braces in Washington. Hagar, who is medical and social services reporter for the Union-Bulletin, in Walla Walla, sought sources and found statistics that made her jaw drop.

“We should be taking care of people who really have a need,” a frustrated Walla Walla orthodontist, Thomas Utt, D.D.S., told her. “While his office – Walla Walla Orthodontics – is authorized to treat Medicaid-eligible children with braces,” Hagar wrote, “Utt grits his teeth at what he sees as misuse of funds and a lack of clarity over just what ‘medically necessary’ means when it comes to correcting kids’ teeth.”

Here, Hagar tells us more about how she tackled the reporting that led to her July 5 package “State Foots Skyrocketing $27 Million Bill for Braces” and what she is learning about orthodontic benefits under Medicaid. She also shares some wisdom on what to do when no one is returning your calls on an uncomfortable subject. Read how she did her reporting.

Clearing up confusion about those enrolled in both Medicare, Medicaid

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 and Home Care Technology report. She is a senior fellow at the Center for Health, Media & Policy at Hunter College in New York City, and co-produces HealthStyles for WBAI-FM/Pacifica Radio.

dual-eligiblesDual eligibles are low-income elderly or disabled people enrolled in both Medicare and Medicaid. The distinctions are sometimes bewildering. It’s easy to confuse which program pays for what, what each agency considers “appropriate” care, what factors go into measuring outcomes and how the separate structures of Medicare and Medicaid affect costs and quality.

According to the Congressional Budget Office, in 2009, the federal and state governments spent more than $250 billion, combined, on health care benefits for the 9 million dual eligibles. There is growing concern about the high costs of dual eligibles and the type of care they receive. They may be treated by a variety of health care providers who are not coordinating their care, potentially increasing costs and worsening outcomes.

Many states are already struggling to meet current Medicaid demand, and as boomers age, more stress will be placed on an already fragile system. Learn more about dual eligibles and what issues to look for in your state with this tip sheet.

Tennessean reporter investigates complaints over Medicaid dental provider

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.

Tom Wilemon

Tom Wilemon

Quite a few folks in Tennessee are upset right now with DentaQuest, the giant dental benefits company that took over the contract to provide oral health services to poor kids under the state’s Medicaid program earlier this year.

Two hundred black dentists are riled that they were cut from the provider network. The state dental association has withdrawn its support for DentaQuest’s contract. And some consumers (including a group home operator) are saying the company is making it harder for patients to get the care they need.

Meanwhile, company officials insist that no child with TennCare benefits has lost access to dental care under their watch. They defend their performance in Tennessee, saying that screenings have increased and that the state network of 864 providers – one for every 857 patients – exceeds nationally recommended standards.

What is going on? The Tennessean’s Tom Wilemon has been working to find out. His story last month offered a look at the situation.

In this Q&A, he gives an update and some additional insights into his reporting. He also shares some wisdom with others who might find themselves tackling a similar story.

Reporter looks into rise in kids’ orthodontic care in Wash.

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.

Image by Jlhopgood via flickr.

Image by Jlhopgood via flickr.

Though a state investigation has failed to prove that any dental providers committed fraud, scandal still hovers over Texas’ Medicaid orthodontic program.

Now questions are being raised in Washington, where there has been a spike in the number of poor kids with braces. Medicaid orthodontic spending in the state jumped from $884,000 for braces for just 1,240 kids in 2007 to nearly $27 million for 21,369 children last year, Sheila Hagar reported in a July 5 package for the Union-Bulletin in Walla Walla, Wash.

What is going on? Hagar talked to a Walla Walla orthodontist, Thomas Utt, D.D.S., in her quest to find out. Utt has been worrying about the increase and has been raising concerns on the state level.

“We should be taking care of people who really have a need,” Utt told Hagar. But “need” appears to be a moving and subjective target in the state when it comes to braces, Hagar reported. Continue reading