Provide names of other journalists involved.
The Crushing Cost of Care, by Janet Adamy and Tom McGinty. Story was accompanied by a WSJ.com interactive timeline and video.
List date(s) this work was published or aired.
7-Jul-12
Provide a brief synopsis of the story or stories, including any significant findings.
The story showed how Scott Crawford, a 41-year-old heart transplant recipient in Maryland, became one of the most expensive Americans on Medicare. The Journal used a Medicare database and health records to chronicle his 10-month stay in intensive care and offer a window into the forces driving up health spending. Our analysis of Medicare’s billing records found that a sliver of expensive patients account for the majority of the program’s cost. In painstaking detail, the story illustrated the tense fight between doctors, nurses and his family over whether to keep Mr. Crawford alive as his condition deteriorated.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
The story relied on a database that the Journal obtained of Medicare’s billing and treatment records to flesh out Mr. Crawford’s case. The Crawford family gave us permission to secure a complete set of his medical records from Johns Hopkins, along with additional billing records from the hospital. This strengthened the story by giving us a tremendously detailed look at his care and costs.
Explain types of human sources used.
Janet conducted multiple in-person interviews with Mr. Crawford’s family, and also spoke extensively with his main physicians at Johns Hopkins. Numerous interviews with Medicare and Johns Hopkins billing officials helped Janet and Tom make sense of his medical spending.
Results:
The story prompted an outpouring of response, including letters from physicians and hospital directors across the country. Dr. James Baker, medical director at two Massachusetts hospice facilities, wrote: “Your article on the costs of healthcare, especially near the end of life, was nothing short of spectacular, and remarkably accurate.” Added Steven Richard, president of a Pennsylvania home health firm: “I commend you for doing a great job of not passing judgment, but highlighting the many intricate financial and clinical issues.” It prompted a number of readers to share their own stories about the tough decisions and confusion they faced when a loved one neared death. Joe Oliveira of California was moved to contact the Crawfords after reading the story and sent a donation to help care for the son Scott Crawford left behind.
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.
We received no requests for corrections or found that any of the material needed correcting
Advice to other journalists planning a similar story or project.
Harness the power of public records in your reporting. A number of publications have written profiles about end-of-life spending, but most have been first-person accounts of a parent or spouse that were highly personalized. By tapping into the database and medical records, we were able to find a captivating case of one high-cost individual that was distinct in its objectivity and detail.