Story Ideas from the AHCJ 2012 Health Journalism Conference

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April 25, 2012

association of health care journalists, health journalism, reporting on health, barbara feder ostrov, emergency medicaid, hospitalistsAs you may have read in William Heisel's Antidote blog and Reporting on Health member Elizabeth Hanes' member blog, last week's Association of Health Care Journalists' conference was chock-full of story ideas. Here are my top picks.

1. Medicaid Babies: In a panel on health care for undocumented immigrants, I was stunned to hear that about 60 percent of all births in Georgia (nearly 150,000 in 2008) are paid by taxpayers through emergency Medicaid. The federal-state health program for the poor covers women, including undocumented immigrants, for prenatal care, delivery, and 60 days of post-natal care. Across the nation, about 40 percent of all births are paid for by emergency Medicaid. That's a lot of taxpayer money. What's the situation in your state? To get the latest statistics for your state, go to the National Center for Health Statistics Births Page. This JAMA study offers context and history on undocumented immigrants' use of emergency Medicaid.

2. Laborists and Nocturnists. Remember hospitalists? Doctors stationed in hospitals so that your regular doctor didn't have to make early morning and night-time rounds? They've been branching out into "laborist" and "nocturnist" specialties. Laborists are in-hospital baby delivery specialists available so womens' regular ob-gyns don't have to get out of bed at 3:00 a.m. (moms-to-be might want to think about that one for a minute.) Nocturnists are just what they sound like: doctors who work the night shift, as Sandra G. Boodman reported for the Washington Post in 2011. Liz Kowalczyk wrote about laborists for the Boston Globe in 2009 – what's happening in your hospital with hospitalists these days? How do patients feel about having different doctors care for them in-hospital?

One bit of context to think about: with all the rhetoric over continuity of care and a "medical home" for patients, does having these hospital-based specialists actually reduce continuity of care between outpatient and the hospital bed? Is there a danger of patient care falling between the cracks? At least one physician at a panel on primary health care thought so.

3. Health Rankings and Scorecards. I've written before on how to intelligently cover county and other geographic health rankings (hint: they're a starting point, not the whole story). I don't always love the annual stories about the Robert Wood Johnson Foundation's County Health Rankings, because they're usually boosterish. At a panel on health data sets, though, I was intrigued by the visualization and depth of the data in the Commonwealth Fund's Local Scorecard 2012, which offers a starting point for reporting on health in your own community. This scorecard examines differences in health access, quality, costs, and health outcomes in the nation's hospital referral regions (regional health care market data). Here are some of the stories you could pull out of it: how dental care access in your community compares to other areas; how uninsured children in your community get health care; and how well local health care providers do in keeping people out of the hospital for preventable conditions, like diabetes complications. All together now: these scorecards should always be a starting point for your reporting (look for outliers), not the story itself.

Got other story ideas from the conference that you'd like to share? Post them in the comments below.