Provide names of other journalists involved.
Anna Wilde Mathews
List date(s) this work was published or aired.
February 9, 2012, March 15, 2012, August 27, 2012, September 27, 2012
Provide a brief synopsis of the story or stories, including any significant findings.
These stories were part of a yearlong effort to get beneath the surface of radical but little-understood changes in the structure and financial underpinnings of health care. I broke news on important shifts in how doctors are paid — a critical component of payers’ efforts to reduce costs and improve care. In a deeply reported profile, I examined what these shifts mean for individual physician. I investigated the sometimes unexpected consequences of consolidation by medical providers, in higher prices to consumers and employers. And I was the first to document big employers are moving to make health coverage more like a 401k, with a set company contribution and more responsibility for the employee – a significant change that is almost certain to play out more broadly in coming years.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
These stories were part of a yearlong effort to get beneath the surface of radical but little-understood changes in the structure and financial underpinnings of health care. I broke news on important shifts in how doctors are paid — a critical component of payers’ efforts to reduce costs and improve care. In a deeply reported profile, I examined what these shifts mean for individual physician. I investigated the sometimes unexpected consequences of consolidation by medical providers, in higher prices to consumers and employers. And I was the first to document big employers are moving to make health coverage more like a 401k, with a set company contribution and more responsibility for the employee – a significant change that is almost certain to play out more broadly in coming years.
Explain types of human sources used.
In addition to those quoted in the stories, the reporting depended significantly on a broad range of confidential sources in various fields, who gave tips, examples and guidance and put me onto the topics in the first place. They include health-plan executives, hospital-system executives, physicians, employer-benefits experts, human-resources executives, academic researchers and government officials
Results:
The story on the effects of provider consolidation was closely read by regulators and other officials; one example is that legislators in Washington cited the story in asking the state’s attorney general to investigate hospital acquisitions of physician practices.
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.
The hardest part is often getting the numbers to illustrate the situation and clearly explain its meaning, and it requires diligence. There is no one place to get these, and they are hard to come by — health plans will complain about provider consolidation off the record, but rarely share examples; I spent months chasing them down. In the UnitedHealthcare reimbursement story, I had to rely on documents because the numbers hadn’t been shared publicly. In the case of the individual doctor, I had to spend hours with his practice manager to pin down the figures.