1. Provide the title of your story or series and the names of the journalists involved.
Big Hospital Chains Use Clout To Dictate Premiums By Sarah Varney
2. List date(s) this work was published or aired.
Aired on NPR Nov. 19, 2010
3. Provide a brief synopsis of the story or stories, including any significant findings.
Everyone loves a good fall guy, and in the search for someone to blame for rising health care costs, the insurance companies have long held that exulted role. Under the health overhaul, regulators can limit excessive premium increases. But there are no such limits on how much hospitals — which account for one-third of all health care spending — can charge insurance companies for medical care. And why should all that matter to you? As hospitals have consolidated into large chains, they've been able to set take it or leave it prices. And those prices get passed on to you. From our partner Kaiser Health News and member station KQED, Sarah Varney reports.
4. Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
From KHN reporting partner Jordan Rau: KHN used hospital financial data from the California Office of Statewide Health Planning and Development (OSHPD). It allows you to take a look at the different hospital systems, and the other thing which is really unusual, the state requires hospitals to break down revenue by third party payers, such as private insurers, Medicaid, Medicare. Then within each category they break it down by fee for service and managed care types. I was turned on to (the data) by the insurers&who use to figure out what's up with their competitors. There have been academics who use it to track price increases in the private market.
5. Explain types of human sources used.
We wanted (to report in) a community that was small enough to have distinct players, but not so small that no one was willing to piss people off. We wanted to make sure we could interview employers who were small enough to articulate the pressures they were under, but not so big that we'd get pushed into a HR department. I'd talked to some of the big insurers who'd only talk off the record. After talking with them and confirming the general thesis of the story, I asked, who are some of your trusted brokers? Who would know this area really well? Who could talk about what's happened as Sutter came to dominate that market? For radio, it's tough — you've got to have someone who can explain it in a radio friendly way. We landed on a guy who was an everyman, garrulous and articulate. He was also willing to open his books. and not willing to piss people off. I asked him — who are your clients who might be willing to talk? He put me in touch with policyholders, all businesses. To find the family I profiled, I called a young professionals group in the Roseville area and chatted with the guy who ran it. He hooked me up with several individuals, including Christina Anderson, who was very talkative and willing to talk about her family's finances.
6. Results (if any).
N/A
7. Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
N/A
8. Advice to other journalists planning a similar story or project.
The OSPHD data is a good place to start, but Jordan Rau of KHN has a warning for anyone treading in this area: "It's really hard data to work with. You have to be really careful to take risk adjustment into account. It took a lot longer than I wish it had. The best way to work with it is to bounce it off people, including the people who are more likely to be critical of it — we sent the data to all the hospital systems (to get their comments)."