Tag Archives: tulsa world

Tulsa World investigates billing, compensation at ambulance utility

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

The Tulsa World‘s Ziva Branstetter has, for months now, been doggedly investigating the billing practices of the Emergency Medical Services Authority, an agency that provides ambulance service to many residents in and around Tulsa and Oklahoma City. The service is largely funded by utility fees which, unless users specifically opt out, should cover the payers’ out-of-pocket costs.

Instead, Branstetter has found, EMSA has followed a number of apparently deceptive billing practices, including sending bills that list a “due from patient” balance of something like $1,100, even though that amount is actually covered by the utility fee. It also unilaterally implemented a policy making patients responsible for the balance if they don’t provide insurance information within 60 days, while providing lavish benefits to employees and executives.

Branstetter’s latest efforts have been directed toward innovative ways of proving EMSA’s sketchy billing practices, as well as uncovering the details of benefits given to the public utility’s CEO. For a full list of Branstetter’s stories on the subject, databases and documents, as well as a summary of the issues at hand, visit the World‘s excellent landing page for the investigation.

Behind Oklahoma’s nation-leading access-to-care problems

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In February, the New England Journal of Medicine ranked Oklahoma as the worst when it came to access to medical care. With help from a California Endowment Health Journalism Fellowship, Tulsa World reporter Shannon Muchmore sifted through reams of data to emerge with a three-part series helping readers better understand the state’s unique health care delivery challenges.

Fans of data analysis and numbers will want to dive straight into the first installment. According to Muchmore, 66 of Oklahoma’s 77 counties contain “Health Professional Shortage Areas, which means “they don’t meet the national standard of one physician for every 3,500 people.” And those doctor-patient ratios aren’t improving.

The state is facing a severe shortage of doctors as the population ages. Adding to that, as many as 180,000 people are poised to receive insurance when provisions of federal health-care reform kick in 2 1/2 years from now.

What’s behind that shortage? Muchmore enumerates the key drivers.

Medical schools are not increasing their class sizes, residency slots are hard to come by, and doctors are choosing to locate in other states.

The last two factors go hand-in-hand, as doctors often practice where they have their residencies. Without a connection, they have little reason to locate in a rural area.

The state is not well-positioned to handle a further deterioration in its health-care system. Oklahoma consistently ranks among the worst states for obesity, diabetes, smoking, heart disease and overall health. It has the least improvement in the country in age-adjusted death rate since 1990.

In the second installment, she examines the link between disparities in access to medical care and disparities in life expectancy and other indicators throughout the state, with a special focus on Oklahoma’s most rural counties.

In the final piece, Muchmore looks at the future of health care provision in Oklahoma and the key role that physician extenders, such as nurse practitioners and physician assistants, are poised to play.

Keep an eye on the AHCJ website for an upcoming “How I did it” article from Muchmore in which she shares how she did the reporting on this project.

Joplin hospital staff took action during disaster

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

If you haven’t already, take 90 seconds to read Tulsa World reporter Michael Overall’s brief, powerful account of how emergency preparedness translated to emergency action at the hospital caught in the center of the May tornado in Joplin, Mo.

joplin-hospital

Photo by Red Cross: Carl Manning GKCARC via Flickr

The staff had practiced severe weather drills and evacuations hundreds of times but, as one administrator told Oklahoma colleagues, “There’s no way you can plan for an F-5 tornado.” Nevertheless, Overall writes, the well-drilled staff of St. John’s hospital “evacuated all 183 patients in just 90 minutes with no major injuries,” a sentence you won’t appreciate until you read Overall’s narrative based on a hospital administrator’s talk at a conference for regional emergency workers.

For those of you looking for story ideas, you might look into local hospitals’ disaster plans. Have they really planned for every contingency? Certainly there are things no one can plan for, but it’s worth reading the story from this hospital and evaluating disaster plans with those events in mind.

For more, read AHCJ’s roundup and review of Joplin tornado coverage.

Papers combine forces to investigate group homes

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Reporters from The Oklahoman and the Tulsa World teamed up to report on Oklahoma’s residential care homes and “Intermediate Care Facilities for the Mentally Retarded,” which are homes for developmentally disabled people. [Oklahoman | Tulsa World]

In their review of more than 40,000 records from federal, state and local agencies, including inspection and investigative reports and letters, the reporters found more than 800 violations, including inappropriate medical care, abuse and neglect. Four cases involved the death of a patient.

Inspectors documented residents who were covered in feces, stolen from, or left to sleep on dirty mattresses.

Some were supervised by felons. Others lived in buildings infested with ants, cockroaches and mice.

At least two people were allegedly raped.

Residential care homes, intended for people who are ambulatory and don’t require routine skilled nursing care, are only inspected once every two years.

The reporters created an online database from the records. The state’s health department is in the process of scanning inspection and investigation reports of group homes to put them on its Web site, a project it expects to complete by the end of the summer.

The report also looks at what a proposed cut in funding might mean for Oklahoma’s group homes and how current shortfalls are delaying community care services for thousands.

The project was done by Tulsa World reporters Ginnie Graham, Gavin Off and Michael Overall and Oklahoman reporters Sonya Colberg, Ann Kelley and Vallery Brown. A sidebar explains more about the series.