Tag Archives: montana

Journalist digs through data sources to show how deal changed Montana’s insurance market

scales of justiceCovering health insurance in a less-populated state can be a significant challenge for journalists because most often, there’s not enough enrollment data to support robust reporting on trends that affect consumers.

Katheryn Houghton learned this lesson when working as a daily news reporter for the Bozeman Daily Chronicle in Montana. In May, she left the Chronicle and now works as a freelance health care journalist in Missoula. Continue reading

Troubled Mont. nursing home illustrates special federal status

Reporters looking to implement the tricks they picked up at AHCJ 2011 or one of our workshops can look to Billings (Mont.) Gazette reporter Cindy Uken, whose story about a dangerously deficient local nursing home was carried by inspection reports and her understanding of federal programs and regulation.

The program in question, known as the Centers for Medicare and Medicaid Services Special Focus Facility Initiative, has singled out 49 of the nation’s 16,100 nursing homes based on what it calls “a history of serious quality issues.” In the case of the Montana nursing home, these problems included serious bed sore issues, possible abuse and a failure to get to the bottom of patient injuries of “unknown origin.” Homes in the federal initiative are treated to about two inspections a year – twice the regular rate.

The Centers for Medicare and Medicaid Services (CMS) selects facilities for the improvement program after receiving reports from state agencies. More nursing homes could be candidates for the improvement program, but a lack of funding restricts how many participate, said Mike Fierberg, public-affairs officer for the CMS Region 8 office in Denver.

After 18 to 24 months in the program, officials aim to have the problem facilities either improve their quality, lose Medicare and Medicaid funding or, if they’ve shown progress, to keep improving apace.

When CMS released the most recent list of homes in the SFFI, it released them in a PDF. AHCJ has converted and posted the list as Excel and HTML files to make searching the list easier for reporters. More information about nursing home quality is available from CMS and in AHCJ’s slim guide, “Covering the Health of Local Nursing Homes.”

Rural health on the frontier

A defining feature of reporter David Wahlberg’s ongoing look at rural health care for the Wisconsin State Journal has been his willingness to look beyond the state’s borders, as with his recent piece on health care navigators in Kentucky.

In his latest installment, he looks to Montana, not just for a model, but for perspective. In Montana, he finds that all rural health challenges are created equally, and that the rural areas of the Mountain West and western Great Plains are so remote that the term “rural health” just doesn’t do their situation justice. Instead, they deal with “frontier health,” where the only hospital in driving distance can’t afford to deliver babies, and hospitals have to fly patients hundreds of miles just so they can have access to adequate blood supplies.

Only 4 percent of Wisconsin residents live in frontier counties. In Montana, that number is 54 percent. Wyoming is even higher. “Frontier” counties are generally considered to be those with a population density of fewer than seven people per square mile. For those interested, the State Journal included a map of such counties alongside the story.

Cannabis carpetbaggers crisscross California

The Redding Record Searchlight‘s Ryan Sabalow paints a classic tale of the principled old guard taking a stand against exploitative, profit-hungry carpetbaggers, one that just happens to take place in the wild west of northern California’s medical marijuana clinics. Since last year’s federal directive effectively allowed the state’s clinics to operate with impunity, a number of traveling physicians have come up from the south to open clinics in this northern outdoor recreation hub which more than 100,000 residents call home.

redding1At $150 for each brief exam (no tricky medical procedures involved), the granting of medical marijuana recommendations is low-overhead work that holds the promise of substantial profit. A physician would need to see just 30 patients a day to gross more than $1 million a year, Sabalow writes. One local Redding doctor (the only one who specializes in pot, really) has found that the newcomers seem to care more about money than medicine.

[Dr. Terrence Malee] gave the example of a cage fighter who came in to his office trying to intimidate him into getting a recommendation that allowed him to have 7 ounces of marijuana in a week, when most patients are only recommended 2.

“I said, ‘Look, bud, the last time you went to the doctor and asked him for 1,000 Vicodin, did he give it to you? No. Well, I’m not going to give you 7 ounces either,” Malee said, laughing.

In a companion piece, Sabalow looks beyond California’s borders, thanks in part to the responses of other AHCJ members via our electronic discussion list. In particular, he looks at Montana, where traveling “cannabis caravans” have swelled the ranks of medicinal marijuana users in every corner of the state and Colorado, where five doctors accounted for over half of the state’s medical marijuana recommendations.

The Record Searchlight‘s editorial board followed up with an piece that questions the wisdom of making medicinal marijuana so easy to obtain.

But it’s hard not to see a stretching of the state’s groundbreaking 1996 Compassionate Use Act beyond all recognition when patients arrive not thanks to a referral from their family doctor, but after hearing a 30-second ad on the local rock station.

For more on Colorado’s effort to reign in physicians who recommend medical marijuana, see Eric Whitney’s piece for Colorado Public Radio.