List date(s) this work was published or aired.
May 6, 2012; May 14, 2012; June 24, 2012; July 22, 2012; Sept. 23, 2012; Oct. 21, 2012; Nov. 17, 2012
Provide a brief synopsis of the story or stories, including any significant findings.
Throughout 2012, Plain Dealer reporters Dave Davis and Sarah Jane Tribble explored the world of medical billing and revealed the business side of medicine that doesn’t work for patients. Through monthly stories, including one special section, Plain Dealer readers learned how hundreds of people are involved in the creation of a single patient’s bill, and the potential for error inherent in the process. They read how patients’ suffering often starts all over again after leaving a hospital’s care, as confusion and anger over hospital billing are often overwhelming. The Plain Dealer also revealed common pricing strategies, such as the extra facility fees that are commonly charged just because a doctor’s office is part of a larger health system.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
The Plain Dealer used an online survey to gather reader experiences that we then managed using a Microsoft Excel spreadsheet. The survey included multiple categories where readers could explain their concerns, which institutions were involved and whether the problem had been resolved. Readers also provided contact information, allowing us to reach them for follow-up reporting. The spreadsheet provided an easy way to calculate which institutions consumers were most concerned with and what the most common problems were. No public records were requested, however sources at health systems provided internal billing-system flow charts and copies of documents used to bill federal and private payers.
Explain types of human sources used.
Preexisting relationships with area health care executives at hospitals and insurance companies provided for many background conversations that helped shape the arc of the stories. Readers also became an intricate part of the series as we explored their stories and billing issues.
Results:
From the start, readers connected with the stories, responding in force with their personal tales of grief and frustration. In some cases, when we explored a readers’ issue to use as an example in a story, we were able to resolve the problem. In one such instance, Medicare admitted they had made a billing mistake and excused about $24,000 in billed charges. Local hospitals also admitted error and removed erroneous charges from bills. Finally, the Cleveland Clinic’s top director over patient financial services left abruptly in November after much of the series, which focused heavily on patient complaints about the Clinic, had run. The health system said his departure is not related.
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 correction, clarification or challenge regarding accuracy ran in relation to this series
Advice to other journalists planning a similar story or project.
There is a reason medical billing is fraught with error. It’s so complicated, and so many “hands” touch each bill, that even those most intimately involved often can’t explain what went wrong, or how to fix it. Our advice: This story isn’t easily explained, and there are no simple answers. Tackling stories on this topic requires a significant commitment of resources, and reporters who understand numbers as well as systems and structures. We plan to continue to probe for answers, and work to empower readers so that they can do the same. There will be no shortage of stories on this topic as health care reform rolls out in the years ahead and the guidelines and rules continue to evolve.