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Reporter filled in gaps of a state report to provide fuller picture of hospital prices Date: 03/24/17


Claire Hughes

By Claire Hughes

It wasn’t the story about hospital prices that I’d hoped to write, yet it earned me some recognition.

A respected nonprofit foundation offered me an important report under embargo, and I responded enthusiastically. It was based on data I could not get myself – actual contracts between hospitals and health insurance companies in New York, including those in the Capital Region, which I cover. The conclusion, though a confirmation of studies done in other areas, was nonetheless potent at a time of increasing hospital consolidation: In New York, the only determinant of a hospital’s price is its market power.

The New York State Health Foundation report, was, in fact, well-done. The challenge it created for me was how to bring alive important, but somewhat wonky information for an audience who had a deep interest in the cost of their health care, but not so much in policy.

Initially, I thought I would report on the broader findings of the study while illustrating its points with local examples. However, I was stymied by the researchers, who did not want to “out” any single hospital as least or most pricey. Those details were intentionally cloaked.

Struggling for a way to highlight the conclusions with specifics, I went to a state database of hospital charges. Using the report, I made an educated guess about which local hospitals might be the most and least costly for a couple of procedures. I then fashioned my lede using that data, then realized why it was wrong and why I had never used the state data before as the basis for an article. The state collects hospital charges that few patients – except for the increasingly rare uninsured individual – ever actually pay. They are not based on the negotiated fees in contracts or insurance claims.

That brought me back to the value of the report in my hands, and also my challenge.

I knew my editors (and I) would be unsatisfied with an article lacking solid prices, or anecdotes from actual patients – hard to obtain in a few days’ time.

So I did what I could: the basic journalistic work of looking for people with varying perspectives on hospital pricing. Some were hesitant to say much, given that I was summarizing an embargoed report that they could not study themselves. But others shared their expertise and insights. I went to the hospital industry itself, plus an insurance representative, a consumer advocate and some state lawmakers. I also spoke with agency staff in Massachusetts, where concern over hospital price variations has led to new monitoring.

I wrote with an understanding of the basics of health journalism too: Avoid jargon. Give people context. Explain why it matters. Maybe I did not have examples of what this meant for someone’s personal bank account, but I could highlight the fact that hospital prices perhaps were not based on what they had thought, such as a hospital’s performance. I sprinkled Into my narrative what local examples there were in the report.

I ended up with an acceptable story. I was delighted, but admittedly surprised, when it was recognized by veteran health journalist Trudy Lieberman as a “fine, meaty” story in a Health News Review piece about covering hospital prices. I didn’t think I’d done anything special and had even fallen short of my expectations.

In a later telephone conversation, Lieberman told me no other journalist had done much on that important study than merely report its findings. (I poked around myself and, naturally, she was right.) So I stood out for doing the basics.

I suppose that may be the lesson to this story, at least for me.

At a time when there are fewer and fewer of us health care beat reporters at mid-sized regional newspapers like mine, we need to be selective about how we spend our time. If we decide a topic is important enough for our attention, then we must do more than merely report what one source of information has to say.

Yes, that’s basic. But my experience perhaps is an important reminder as our ranks are diminished and a new federal administration seeks to disseminate “alternative facts.” If we stick to the fundamentals, we serve our readers well.

Claire Hughes (@clairehughes) primarily covers health for the Times Union in Albany, N.Y.