- npr.org/player/v2/mediaPlayer.html?action=1&t=1&islist=false&id=138932704&m=138946302
- npr.org/player/v2/mediaPlayer.html?action=1&t=1&islist=false&id=143308697&m=143333766
- kaiserhealthnews.org/Stories/2011/December/08/medicare-critical-access-rural-hospitals.aspx
- kaiserhealthnews.org/stories/2011/august/03/bisbee-arizona-community-hospital.aspx?referrer=search
List date(s) this work was published or aired.
2 parts on NPR: 8/3/11, 12/6/11
Provide a brief synopsis of the story or stories, including any significant findings.
In two stories, KHN reporter Jenny Gold probes the finances of two rural hospitals as each tries to cope with a rapidly-changing political and marketplace landscape. Part one: Just five miles from the Arizona-Mexico border is Copper Queen hospital. This is the story of how CEO Jim Dickson transformed the nonprofit rural hospital with just 15 beds from a struggling facility into a thriving business, which now has surplus revenues of 5 to 10 percent, a margin much higher than rural hospital averages. Part two: In Amite, Louisiana, Hood Memorial Hospital hasn’t been full in at least two decades. Hood scrapes by with extra funding from the federal government for “critical access hospitals”occupied. Last year, Hood posted a $700,000 loss on its $7.5 million in total operating expenses. One of the few bright spots on Hood’s balance sheet: the extra money it receives from the federal government through a program for critical access hospitals — small facilities that receive a higher Medicare reimbursement rate to help keep them afloat. But that funding may now be in jeopardy.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
-Searches through rural hospital databases to identify examples to illustrate the issues. -990s requested through hospitals and Guidestar, financial statements and payer mix documents from hospitals -Searches through CMS, CBO and MedPAC records on critical access hospitals -Presidential budget, documents from Ways and Means Committee, Supercommittee, etc – Data from the American Hospital Directory based on hospital’s Medicare filings -Many searches of medical journals for articles on ER boarding -Data, budget from Arizona AHCCCS (Medicaid) program -Letters and documents between Arizona governor Jan Brewer and HHS Secretary Kathleen Sebelius -No FOI or public records act requests. Much web searching to find communities, hospital districts, etc.
Explain types of human sources used.
-Lawyers representing CAHs, rural hospitals explained details of CBO and supercommittee recommendations – Massive number of phone calls to identify excellent examples to illustrate the issues, including conversations with rural hospital CEOs across the country -Many conversations with experts at the National Rural Health Association, Rural Policy Research Institute -State and national hospital associations -Academic experts on rural health -State officials from health departments in Arizona and Louisiana -Patients, providers and administrators from all hospitals profiled, including the mayor of Bisbee, AZ
Results:
Both stories were provocative, generating comments on NPR’s Facebook page and robust traffic to KHN’s and NPR’s websites. The CAH story in particular inspired a lot of conversation in the rural health community about the CAH program, including blog responses from several major organizations. Analysts from the Department of Health and Human Service’s Office of Inspector General contacted reporter to request a meeting about a new project on the CAH program. Decisions have not yet been made about whether to make cuts to the CAH program.
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.
No.
Advice to other journalists planning a similar story or project.
We found this to be an exceptionally rich area for potential stories. With the health law, state budgets being squeezed, Medicare undergoing payment turmoil, hospitals are in the middle of a turbulent time. We heartily recommend talking with major players: hospital executives, advocacy groups, consumer groups, government officials and health economists to identify areas of tension and where there are no good guys or bad guys.