List date(s) this work was published or aired.
Sunday, Nov. 27, 2011
See this entry.
Provide a brief synopsis of the story or stories, including any significant findings.
With medical costs spiraling upward and state-paid insurance coverage evaporating, why are hospitals building expensive emergency rooms and encouraging patients with sprains and cuts to come there for care? To try to answer that question, Ostrom looked at the building boom, the incentives offered hospitals in the state (almost all of which are nonprofit), insurance reimbursements, a state program that helps float tax-exempt bonds for hospital construction, property-tax exemptions and, briefly, at the state’s Certificate of Need program. We also talked to hospital CEOs and other officials about why they’re building new ERs and how they calculate that such construction is good for their bottom line.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
I looked at state records of tax-exempt bonds by hospitals from the state’s Health Care Financing Authority, Department of Revenue statistics on property-tax exemptions, and Certificate of Need applications and approvals for hospital expansions (not including free-standing ERs, since the CON process only covers facilities with beds). Internet searches for hospital expansions/ER building projects.
Explain types of human sources used.
Hospital officials, state Legislators, Puget Sound Health Alliance board chairman (the organization analyzes costs and quality of local health systems to help employers better purchase health care for employees), medical director for one of the state’s largest health insurers, the director of the Health Care Financing Authority, director of the state’s facilities licensing program (administers the CON program), Department of Revenue spokesman, and Washington State Hospital Association, but since they didn’t have a grip on expansions/construction, I pretty much had to contact each hospital in the area.
Results (if any).
Two panels set up at the 2012 “State of Reform, Washington Health Policy Conference” to talk about the issues raised in the story, according to the conference organizer. He said the story was “one of the most impactful stories of the year.” Legislative proposals likely will go forward (begun in earlier session).
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.
I covered bits and pieces of this story over several years before I was able to step back and see the big picture, which seemed like it was worth exploring. But because I took a wide look at this big-picture story, including not just ERs but all construction. I soon realized I had bitten off too much and the story had to get narrowed down to get into the paper in a reasonable length. Also: I had to carefully vet some of the claims made in proposed legislation, some of which turned out to be misleading. It’s disappointing to find a fact that looks so good at first glance fall apart on closer inspection, but I’m glad I made the effort.