How Journalists Overcome Challenges Reporting Hospital Price Data

Unmasking Hospital Pricing: A Journalist’s Journey

A recent investigative series exposed the shocking truth behind Parkview Health, a hospital system demanding some of the highest prices in the nation. Patients and employers alike are struggling to cope with the financial burden. “Over more than a decade, Parkview Health has demanded that the people of north-eastern Indiana and north-western Ohio pay some of the highest prices of any hospital system in the country,” the reporters revealed.

Uncovering this alarming reality wasn’t easy. Journalists often face a daunting challenge when tackling the complexities of healthcare pricing. Gathering accurate data can be a labyrinthine process, as Michael Craft, a reporter who spearheaded this investigation, can attest. “for this story, we needed to be able to do two things,” he explained. “We needed to show how much care costs at this hospital and how that changed over the years.”

Accessing hospital pricing data is no simple feat.While hospitals and insurers are legally required to publicly post their prices under regulations set by the federal Centers for Medicare and Medicaid (CMS), compliance isn’t global. Craft observed a delicate balancing act within the insurance industry. “insurance companies want some of the data released because it helps them negotiate with hospitals, but also they don’t want to tick off the hospitals,” he said. This tension often leads insurers to share pricing information selectively, making it accessible to hospitals and a limited circle of researchers.

“They don’t want anyone touching that data as it’s the bread and butter behind the power health insurers have in negotiations,” Craft remarked.This control over pricing data allows insurers to wield meaningful influence in their dealings with employers,who ultimately bear the brunt of healthcare costs for their workforce.

To demonstrate the upward trend in Parkview Health’s prices,Craft needed to delve deeper than raw figures. He turned to the commercial-to-Medicare ratio,a crucial metric that compares the amount employers pay for healthcare compared to what Medicare,the government health insurance program,reimburses. This ratio illuminates the exorbitant markups private payers encounter.

Craft relied on surveys conducted by the RAND Corporation, a reputable research institution, which has been tracking these ratios as 2017 for various employer coalitions. The may 2023 RAND report, titled “Employers Pay 254% More for Hospital Care Than medicare, Report Says,” provided valuable insights into the stark price discrepancy between commercial and Medicare rates.

“RAND makes available for purchase this big dataset that includes the commercial-to-Medicare ratio,” Craft explained. “A simple way to explain that is that they look at how much employers pay compared to Medicare.”

Unmasking Hospital Pricing: A Journalist’s Journey

A recent investigative series revealed a disturbing truth about Parkview Health, a hospital system demanding some of the highest prices in the nation, leaving patients and employers struggling to make ends meet. The reporters uncovered a pattern of exorbitant charges over more than a decade, stating, “Over more than a decade, Parkview Health has demanded that the people of northeastern Indiana and northwestern ohio pay some of the highest prices of any hospital system in the country.”

Unveiling this reality wasn’t without it’s hurdles. Journalists frequently enough face a monumental challenge when tackling the complex world of healthcare pricing. Gathering accurate data can be a labyrinthine process, as Michael Craft, the reporter who spearheaded this investigation, can attest.

Interview with Michael Craft

Archyde: Michael, your recent investigation into Parkview Health’s pricing practices shed light on a critical issue facing many Americans. Could you describe the biggest challenges you faced in uncovering this story?

Michael Craft: “For this story, we needed to accomplish two key things,” he explained in an interview. “we needed to demonstrate how much care actually costs at this hospital and how those costs have changed over time.”

Accessing hospital pricing data isn’t as straightforward as it might seem. While hospitals and insurers are legally obligated to publicly post their prices under regulations set by the federal Centers for Medicare and Medicaid (CMS), compliance isn’t universal.

Craft’s experience with the commercial-to-Medicare ratio highlighted the importance of adopting robust research methodologies. “When I looked at the commercial-to-Medicare ratio, I got a lot of nonsense numbers as I hadn’t adopted some of their methodology to clean and narrow the data set,” he admitted. Medicare data often includes a mixed bag of hospital types, including smaller facilities and nursing homes, which can skew overall estimates. He added, “When you use researchers’ methodology and the cleaning steps they use that have been peer-reviewed, you get a much better and more defensible methodology.” This dedication to rigorous methodology empowers journalists like Craft to stand behind their findings with confidence, ready to face scrutiny with a solid and clear approach.

The Invisible Cost of Healthcare: How Hospitals Inflate Prices and Squeeze Patients

Insurance companies hold a powerful position in the healthcare industry, wielding control over pricing data that heavily influences negotiations with hospitals. This delicate balance often leaves patients facing hefty bills, caught between the ambitions of insurers and the rising costs of care.Michael Craft,a seasoned investigative journalist,delved deep into the labyrinthine world of healthcare pricing,exposing the often-hidden methods hospitals use to inflate costs. He found that while insurance companies crave access to this data for leverage in their negotiations, they’re also wary of upsetting the balance. “They don’t want anyone touching that data as it’s the bread and butter behind the power health insurers have in negotiations,” Craft remarked. This control over pricing information allows them to exert significant influence over employers, who ultimately bear the brunt of healthcare expenses for their employees.

To uncover the truth behind Parkview Health’s rising prices, Craft looked beyond raw figures. He focused on the commercial-to-Medicare ratio, a critical metric that compares the amounts employers pay for healthcare compared to Medicare reimbursements. This ratio vividly illustrates the exorbitant markups private payers face.

Drawing on data from the respected RAND Corporation, Craft highlighted the stark price discrepancies between commercial and Medicare rates. “RAND makes available for purchase this big data set that includes the commercial to Medicare ratio,” Craft explained,“A simple way to explain that is that they look at how much money is coming in through different channels to estimate what a commercial payer,such as an employer,would pay.”

Over a 13-year period, his analysis revealed a disturbing trend: hospitals within the Parkview Health system consistently ranked among the top 10% most expensive nationally, on average. Furthermore, Parkview Health’s expansion – acquiring six other hospitals and establishing a vast network of clinics – solidified their control over patient referrals, giving them increased leverage in negotiations with insurers and ultimately driving up prices.

craft’s work underscores the vital role of robust data analysis in investigative journalism. He emphasizes the importance of adapting methodologies from researchers to ensure accuracy and credibility.“When I looked at the commercial-to-Medicare ratio, I got a lot of nonsense numbers because I hadn’t adopted some of their methodology to clean and narrow the data set,” he explained.Medicare data often encompasses a mix of hospital types, including smaller facilities and nursing homes, which can distort overall estimates. By incorporating peer-reviewed cleaning and narrowing techniques used by researchers, Craft was able to obtain a more reliable and defensible analysis.

Craft’s findings shine a light on a crucial problem in the healthcare system: the lack of openness in pricing. by shining a spotlight on how hospitals manipulate costs and exploit their market power, his work empowers patients to become more informed consumers and advocates for change.

The Urgent Need for transparency in Hospital Pricing

The cost of healthcare is a pressing issue for individuals and employers alike. Understanding the true expenses associated with hospital care is crucial for making informed decisions. Investigative journalist Michael craft, in a recent interview, underscored the importance of transparency in hospital pricing, emphasizing it as a cornerstone of building trust with the public.

“This commitment to methodological rigor must be essential for building trust with your audience,” stated Archyde,highlighting the need for robust and transparent research.

Craft echoed this sentiment, stating, “Absolutely. This commitment provides journalists like me with the confidence to stand behind our findings and face scrutiny with a robust and obvious approach.”

Craft’s work aims to shed light on this critical issue, advocating for greater transparency and accountability in hospital pricing. “My hope is that this investigation will shed light on this critical issue and lead to greater transparency and accountability in hospital pricing,” he explained. “Patients deserve to know the true cost of their care, and employers deserve a fair deal. We need to push for systemic change that empowers both.”

What specific challenges did Michael Craft encounter when attempting to obtain and analyze hospital pricing data from Parkview Health?

Interview with Michael Craft

Archyde: Michael, your recent examination into Parkview Health’s pricing practices shed light on a critical issue facing many Americans. Could you describe the biggest challenges you faced in uncovering this story?

Michael Craft: “For this story, we needed to accomplish two key things,” he explained in an interview. “we needed to demonstrate how much care actually costs at this hospital and how those costs have changed over time.”

Accessing hospital pricing data isn’t as straightforward as it might seem. While hospitals and insurers are legally obligated to publicly post their prices under regulations set by the federal Centers for Medicare and Medicaid (CMS), compliance isn’t worldwide.

Craft’s experience with the commercial-to-medicare ratio highlighted the importance of adopting robust research methodologies. “When I looked at the commercial-to-Medicare ratio, I got a lot of nonsense numbers as I hadn’t adopted some of their methodology to clean and narrow the data set,” he admitted. Medicare data often includes a mixed bag of hospital types, including smaller facilities and nursing homes, which can skew overall estimates. He added, “When you use researchers’ methodology and the cleaning steps they use that have been peer-reviewed, you get a much better and more defensible methodology.” This dedication to rigorous methodology empowers journalists like Craft to stand behind their findings with confidence, ready to face scrutiny with a solid and clear approach.

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