List date(s) this work was published or aired.
Sept. 9, 2011; Sept. 15, 2011; Oct. 5, 2011; Nov. 25, 2011
Provide a brief synopsis of the story or stories, including any significant findings.
As a national healthcare reporter based in Washington, I look for ways to make the complex world of health policy and politics understandable to readers. I have tried to explain the substance and political context around the Affordable Care Act and the backlash against it. I track how the Obama administration and state leaders across the country are implementing the law. And I try to stay abreast of changes in the delivery of healthcare to inform readers about a rapidly changing healthcare landscape. This entails intensive research into the technical aspects of health policy. I make extensive use of data and a network of national and local sources nationwide. And I regularly travel the country to illustrate the impact of health policy decisions made in Washington. Healthcare Erodes Under Perry – A look beyond the headlines at the implications of Texas’ high rate of uninsured amid Gov. Rick Perry’s insistence that his state didn’t need federal Health Policy. State’s Ills May Weaken Health Policy – An examination of how budget struggles are jeopardizing implementation of the Affordable Care Act in a place that was supposed to be a national pace-setter. Trying to Heal a System’s Flaws – A profile of Dr. Don Berwick, focusing on his path-breaking work on quality and his efforts to bring that to the task of implementing the Affordable Care Act. Gaps Raise Price of Indigent Care – An on-the-ground illustration in Los Angeles of the challenges of rationalizing the delivery of healthcare to low-income patients, a key goal of federal Health Policy.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
Most of my stories rely heavily on data and/or technical research to provide the foundation for any conclusions that are illustrated with human sources and on-the-ground reporting. In Texas, that meant using state-by-state data on leading indicators of population health and other measures of quality, including mortality rates, hospital readmissions and access to basic care such as dental visits. I literally spent months reading leading texts on quality improvement theory and systems engineering in multiple industries to understand Berwick’s efforts to bring the discipline to healthcare. And to research the costs of duplicative care in safety net hospitals in Los Angeles, I convinced local providers to compare their patient data to find overlaps, and we partnered with the American College of Emergency Physicians to conduct a national survey of doctors to bolster on-the-ground reporting about waste in local ER’s.
Explain types of human sources used.
I try to use national and local healthcare experts to provide the context for stories about health policy, and then spend the time on the ground to find the human beings and places where policy is being implemented. In Texas, I spent several days in the town of San Angelo visiting clinics and the local hospital to see the impact of low rates of insurance coverage. In inner city Los Angeles, I spent two nights in the emergency room to see how the lack of records and coordination results in terrific waste. To profile Dr. Berwick, I visited a hospital in Atlanta with him, sat in on multiple visits he had with stakeholder groups in Washington and elsewhere and interviewed him multiple times in his office and elsewhere. And to understand California’s struggles with Health Policy, I sat down with state officials in Sacramento, worked sources in the Dept. of Health and Human Services and reached out to providers such as Sharp Coronado Hospital in San Diego.
Results:
I’d like to think that the reporting on Texas helped change the debate over Perry’s record there and that my reporting on Health Policy more broadly has educated readers about the complex world of health policy and helped cut through some of the overheated rhetoric.
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.
In explaining the fast-changing world of health policy, balance the use of solid data and expert opinion with on-the-ground, shoe leather reporting to help readers understand a complicated, politically charged subject.