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ACA project shows how media outlets can partner to produce significant reporting in their region Date: 04/13/17

Mary Meehan

By Mary Meehan 

The Ohio Valley ReSource (OVR) is a collaborative effort of seven public radio stations covering Ohio, West Virginia and Kentucky. The intersection of those three states is the epicenter of the nation’s looming health crisis related to the heroin epidemic. by The Centers for Disease Control and Prevention has designated nearly 100 counties in Kentucky, Ohio, and West Virginia as at high risk for HIV infection for HIV infection.

The 10 counties the CDC identified as highest risk all are in eastern Kentucky and southern West Virginia. Wolfe County, for example, ranks number one.The region, especially Kentucky, has benefited significantly from the Affordable Care Act as hundreds of thousands of people have gained insurance.

We produced a series that ran for several weeks last year, with the intention to update it an occasional series under the same logo as events warrant.

In planning the project, the team was briefed on the impact of the ACA in the region by Simon Haeder, a political science assistant professor at West Virginia University’s John D. Rockefeller IV School of Policy & Politics. Jeff Young, OVR’s managing editor, then led a brainstorming session via teleconference. It was a relatively free-wheeling discussion, with people discussing what they had been seeing on the ground in their communities. The decision was to focus on stories about the tangible impacts to people in how they got care, what could be lost by the ACA’s demise and that likely impact on the local economy.

The series we envisioned would attempt to answer these questions:

  • What is the big-picture impact on rural hospitals and clinics, especially federally qualified health centers (FQHCs)?

  • What is the number of jobs created by the ACA in our three states and the impact if those jobs were lost?

  • What can happen to a community under siege by addiction when substance abuse services disappear? One story focused on a Portsmouth, Ohio, program that closed, leaving 1,000 people scrambling for care.

  • How does one woman struggle to get sober in the panhandle of West Virginia with little support and poor access to transportation?

Team members were surprised by the impact of rural health care in communities. Although I have covered a FQHC in Lexington, one of the Kentucky’s few urban areas, I was shocked how deeply ingrained the centers have become elsewhere in the region and the scope of services they provide.

I also was surprised that Medicaid or Medicare provides up to 70 percent of the revenue received by rural hospitals and health centers. By providing a new revenue stream as the uninsured got coverage, the ACA helped stave off some hospital closings.

Benny Becker of ReSource partner station WMMT in Whitesburg, Kentucky said he learned how far the reach of health care clinics and hospitals go in mountain communities.

“I've been surprised at how rural health centers are really the one category of institutions that aren't under extreme funding pressure, and how that results in them anchoring all kinds of community service initiatives and collaborations,” Becker said.

For example, services offered by the Mountain Comprehensive Care Corporation, which serves five eastern Kentucky counties, include day care and a program providing fresh fruits and vegetables to 700 people who are chronically ill.

Providing these services creates jobs, noted Becca Schimmel of WKMS in Bowling Green, Kentucky, who explored job creation under the ACA. Schimmel said working on the project taught her more about the ACA’s impact on jobs, something not often discussed.

One thing I assumed would be easy to find was how many people get substance abuse treatment through Medicaid. Unfortunately, that number is collected differently from state to state. Kaiser Health News warned us that the statistic would be difficult to find. However, we were able to find some state-specific data offering a snapshot of the impact – which turned out to be substantial. Reporter Aaron Payne, whose beat includes the addiction crisis, also was surprised to learn that the total was not readily available.

OVR data reporter Alexandra Kanik put it this way: “So the biggest thing about doing this ACA series from a data perspective was how much data there is, but how poorly standardized it is across state lines. Each state seems like they're tracking something, but many states aren't tracking the same things.”

“One of our three states had info on how many people total, pre- and post-Medicaid expansion, had access to substance abuse treatment,” she noted.

“Another state actually did have the number of people post-expansion, and the third state only had data on the increases in treatment services, not people.”

The lack of consistency makes it difficult to understand progress and how the different states stand in comparison with each other, Kanik said.

For Glynis Board at ReSource partner West Virginia Public Broadcasting, and photographer Rebecca Kiger, the insights were more personal. The story they produced followed a recovering addict through her home life and work and demonstrated how tenuous recovery could be. Smething most of us take for granted – such access to a car – can be a life-or-death barrier to getting well.

Mary Meehan (@The MaryMeehan) is a 2016 Nieman Fellow at Harvard University and on the staff of the Ohio Valley ReSource, a regional journalism collaborative reporting on economic and social change in Kentucky, Ohio, and West Virginia. With support from the Corporation for Public Broadcasting, seven public media outlets in the three states formed the ReSource to strengthen news coverage of the region’s most important issues.