- kaiserhealthnews.org/stories/2011/march/20/health-insurers-reform-business.aspx
- kaiserhealthnews.org/stories/2011/may/04/insurers-turn-to-clinics-for-cost-control.aspx
- kaiserhealthnews.org/Stories/2011/July/01/unitedhealth-insurers-buy-doctors-groups.aspx
- kaiserhealthnews.org/stories/2011/august/26/managed-care-texas.aspx
List date(s) this work was published or aired.
03/19/11, 05/04/11, 07/01/11, 08/29/11
Provide a brief synopsis of the story or stories, including any significant findings.
Beat: Christopher Weaver covered the managed-care and health services industries, with a focus on how insurers are moving to mitigate or profit from a changing regulatory and economic landscape. Insurers, struggling with a recession that bit into enrollment and a new health law that threatened to crimp profits, adopted new strategies: acquiring and operating physician practices, deploying technology to more parts of health care, and increasing their ties to more stable government payers, even as policymakers sought to limit the sway of large insurers and curb spending in Medicare and Medicaid.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
The stories are built on state, local and federal government data that was obtained either through informal requests to agencies, formal state-level public information requests, and sources in government agencies and private companies. Documents used include business entity filings detailing the formation of new corporations, mergers and dissolutions; reports filed with state insurance commissioners; medical board registrations showing physicians’ movement between practices; state Medicaid spending records; minutes of state agency meetings; health plans’ filings with the California Department of Managed Health Care; proprietary data provided by private business research firms.
Explain types of human sources used.
Beyond the insurance executives and policymakers that shaped these stories, there’s a cast of consultants, investment bankers, transaction attorneys, local lobbyists and other operatives that put corporate strategy into action, and helped fill in the details. Also critical were the local competition–doctors, hospitals and rival health plans that parsed the thinking of the much larger companies they were negotiating contracts or vying with for patients. Also, documents obtained from third parties helped coax companies to speak candidly about their strategic deliberations.
Results:
When we began reporting the stories in this series, it was difficult to find sources to provide sweep or reaction to the strategies we uncovered–in part, as we wrote, because so few knew about it. Soon, the financial analysts we spoke to for the stories were using earnings calls to ask about things we’d covered, such as insurers’ physician strategy. Other media followed, and some of these themes became common topics of conversation in managed care circles.
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.
None.
Advice to other journalists planning a similar story or project.
Managed-care as a sector is filled with giant companies. But, most of its business dealings are local–in many markets, the companies still contract with doctors one at a time. Their strategies will often play out at the local level first, riling the folks who negotiate hospital contracts or run medical practices. Talking to those people is a great start, even if you’re looking for a national story.