Tip Sheets

Health analyses for any newsroom

Health care spending is responsible for more than 17 percent of the U.S. economy—one out of every six dollars spent. Journalists, regardless of the size of the area they cover, have an obligation to cover the hospitals, nursing homes, doctors and clinics that provide medical treatment for their readers, listeners and viewers. The good news is that there are a trove of data resources available to make your job easier, whether you have little data experience or are a seasoned veteran.

Two good places to start are data.gov and healthindicators.gov. This tipsheet will provide some others. As with all data sets, these are jumping-off points and may not be stories in themselves. You need to interview experts and your local health officials to determine if the data may provide useful context for your audience.


Medicare is a federal health insurance program for the elderly and disabled. More than 47 million Americans are enrolled in Medicare. The government publishes tools (some better than others) that allow patients to compare hospitals, nursing homes, home health agencies, dialysis facilities and doctors.

ADVANCED TIP: In addition to using the online versions of the comparison sites, you can also download the raw data.

Among the newest resources are Medicare dashboards that allow you to view figures on Medicare spending, prescription drug use and enrollment in your state. The government is also beginning to share previously hard-to-find details on how much money Medicare pays specific hospitals for common procedures.

Click on Medicare Inpatient Hospital Dashboard. Scroll to the bottom of the page, click View Medicare Inpatient Hospital Dashboard. Click Accept on the next page. In the dashboard, you will see the amount of money Medicare spent on hospital care in the past five years. You can choose states and compare them on cost and volume of hospital services. At the top, you will also see a tab called DRG Details. A DRG, diagnosis-related group, is a classification system that groups patients according to diagnosis, type of treatment, age, and other relevant criteria. Hospitals are paid a set fee for treating patients in a single DRG category, regardless of the actual cost of care for the individual.

When you click on DRG Details, you can see the top conditions for which Medicare enrollees are hospitalized, as well as how much Medicare spends on them. At the top, you can choose which year you want to view and you can select by payment or by volume. (The default is by payment). When you click on By Volume, you will see a list of conditions. Click on one and then click on a state. The top 10 states are listed. Once you click on a state, the 10 hospitals with the highest volume are listed, as well as their costs. You will quickly see that some hospitals spend far more than others. There are valid reasons why a hospital can receive more for the same procedure, but some hospitals have also been accused of fraud for artificially padding their bills. Looking into this could make for a great story.

ADVANCED TIP: After clicking on Medicare Inpatient Hospital Dashboard from the main page, select Accessibility Files. That will allow you to download the entire dataset in Excel for your customization and analysis. (Details on the top procedures for every hospital in the country for Medicare patients can be found by downloading the Hospital Compare database. Within the zip folder, the file you want is HQI_HOSP_MPV_MSR. The file Hospital.pdf has an explanation of the fields.)

You may want to look at the other dashboards too—for Medicare enrollment stats, prescription drug benefit and physician/suppliers. Each has an interactive dashboard and Accessibility Files that you can download.


Medicaid is a federal-state insurance program for the poor. More than 66 million people were enrolled at some point in 2010, the most-recent figures available. The federal government and states share the cost of the program, with the feds picking up an average of 57 percent of the costs (it varies by state, with poorer states drawing a larger share of matching funds). Even so, Medicaid often is a state’s second largest expenditure, after K-12 education. See this report from the National Association of State Budget Officers. Unlike other programs, Medicaid is countercyclical, meaning that the demand for it is greatest when the economy is suffering—and when states can least afford it.

Find out details about your state’s Medicaid enrollment and spending. The Kaiser Family Foundation provides a lot of other Medicaid statistics in an easy-to-use format at www.statehealthfacts.org.

ADVANCED TIP: Get additional Medicaid statistics.

National Practitioner Data Bank

The regulation of health professionals, including doctors and nurses, is controlled at a state level. Some states take this role seriously and others do not. State regulatory boards have websites, of varying quality, that often list the names of those disciplined. States are also required to report this information to the federal government—to the National Practitioner Data Bank. Reports to the data bank are confidential but the government puts out a Public Use File that contains non-identifiable information on every disciplinary action reported. Reporters across the country have used this file to write great stories about the lack of oversight in their states.

The government pulled the data bank Public Use File offline last year after a doctor complained about a story written by a reporter for the Kansas City Star. It subsequently republished the information but reporters had to agree not to use the file to identify anyone in the data bank. You can download the records. You can also get a slightly older version on IRE’s website and you DO NOT have to agree to limit how you use the data.

Data newcomers may find the new easy-to-use table on the data bank website helpful to put their states’ disciplinary actions in context. Other resources include the Federation of State Medical Boards annual report and Public Citizen’s ranking of state medical boards.

ADVANCED TIP: Use the files on IRE’s website to explore the cases of physicians who have repeatedly paid malpractice settlements or who have been disciplined by their hospitals but have faced no actions by their state medical boards.

Nursing Home Compare

Nursing homes – or skilled nursing facilities – house more than 1.8 million people in the United States. The residents are there for “sub-acute” care, as opposed to “acute” care in a hospital. Nursing homes are regulated and inspected at the state level, under contract with the federal government. The federal government, through its Medicare and Medicaid programs, gathers this information and stores it in the Nursing Home Compare database.

The database provides a variety of information, including a list of deficiencies cited in the past three years – identifying the nursing home, the regulation violated, type and severity of the deficiency, and some details of the problem. You can use the data to identify nursing homes in your area that have a history of serious problems. Nursing Home Compare also includes ratings – from one to five stars – based on government quality ratings, inspection results, overall staffing, and registered nurse staffing. These numbers give a snapshot of each nursing home.

The Association of Health Care Journalists also provides to members easy-to-use spreadsheet files with the most serious deficiencies and each set of star ratings.

ADVANCED TIP: Go to the next level. Use the deficiency data to focus on specific nursing homes, then request the detailed reports, called CMS 2567, from your state’s agency that inspects nursing homes or the U.S. Centers for Medicare and Medicaid Services. Make sure you get both the inspection violations and the nursing home’s plan of correction. Some states place these documents online. The documents give vital details and help you find people to interview and questions to ask.