1. Provide the title of your story or series and the names of the journalists involved.
KHN Beat Reporting by Jordan Rau
2. List date(s) this work was published or aired.
Jan. 19, 2010; May 18, 2010; Oct. 18, 2010; Nov. 21, 2010
3. Provide a brief synopsis of the story or stories, including any significant findings.
Jordan Rau's pair of stories on surging California hospital prices (October 18 and November 21) broke new ground in the national discussion of rising health care spending. He spent weeks analyzing hospital data compiled by state regulators and interviewed a broad range of experts, hospital executives, employers and others. The stories reached huge state and national audiences when they were picked up by the Bay Area News Group chain of newspapers, KQED radio and NPR. In another story (May 18), Rau, whose beat emphasizes data-based reporting, also uniquely reported evidence that areas of the country widely praised for restraining medical spending were in fact becoming more expensive. This story cast doubt on the widely-held belief that lower-priced areas could be models for the rest of the country. In addition, Jordan used his data-gathering skills to identify a significant problem among people who have insurance: balance billing. Then, he crafted a poignant story about one family facing the burdens balance billing imposes (January 19).
4. Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
No FOI or public records act requests were required. The California Office of Statewide Health Planning and Development (OSHPD) collects data from hospitals and makes it available on the Internet in Excel format.
We analyzed the state of revenue from private insurers, taking into account the number of inpatient stays and outpatient visits, to produce a comprehensive look at how different regions and hospital systems in California collect vastly different prices for an average hospital stay or visit than do others. We also used the OSHPD data to detail the rapid rise of hospital prices for insured patients. The analysis was significant because the prices hospitals negotiate with insurers are confidential. We also obtained actual prices one insurer, Aetna, paid to hospitals for specific common procedures. These prices are made available to Aetna consumers on the web. This allowed us to compare specific prices between hospitals. Then, we matched these data with hospital quality data that is made public in California and published by the California Hospital Assessment and Reporting Taskforce (CHART). For more detail on how Jordan created the databases used, please consult this link and the text in this link.
5. Explain types of human sources used.
We spoke to hospital executives, insurance officials, state officials, academics, insurance brokers, employers, patients and patient advocates. Many spoke on the record about the high costs of particular hospital systems such as Sutter Health and provided actual costs of treatments.
6. Results (if any).
Our stories reached millions of readers and listeners as we published or aired our work in a variety of media. On the California hospital stories, Jordan was interviewed by Bay Area radio stations about the story, as well as the USC Annenberg School of Communications' health journalism program, and our work was incorporated into a presentation for journalists about how to use OSHPD data to write about hospitals. We believe the main result was to bring about a greater understanding and knowledge about the role of hospitals in rising health care prices and how some institutions have the market clout to charge what they want. Both of these points are rarely touched upon in public discussion of health care costs, which generally focus on the role of insurers and government.
7. 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.
8. Advice to other journalists planning a similar story or project.
If you're analyzing data, put the data into an Excel spreadsheet to be able to sort and compare in a variety of ways. This also helps you search for patterns that can inform your reporting. Take advantage of all public data bases. Make sure you have started the work early enough to work with a graphics person, so you can try out multiple ways to display the information and to discover what information you may still need to get or analyze. You might find this link helpful: How KHN Obtained And Analyzed Data For The California Hospital Prices.