The Charlotte Observer and the News & Observer of Raleigh won this year’s bronze award in the Barlett & Steele Awards for Investigative Business Journalism. Reporters from the two papers, both owned by McClatchy, partnered to produce two five-part series analyzing the nonprofit hospitals in their regions.
The series: Prognosis Profits
The papers worked together to gather the data then wrote their own localized stories. Their coverage included a look at the market power the hospitals have with insurers, and tactics the health systems use to get patients to pay.
I spoke with reporters Ames Alexander and Karen Garloch of the Charlotte Observer, and the News & Observer’s Joseph Neff and David Raynor. They gave me some great and varied information so I’ve created subheads to be sure to cover it all.
Joe was assigned to a healthcare project in 2009 as healthcare became a big debate, he says. His research showed insurance and pharmaceutical companies had dominated the coverage, but there was not much about hospitals. But that was as far he got. He shifted to another series for eight months and then another. He also had daily coverage to handle. Six months before the series ran, he worked on it full time, he says.
Karen was the beat reporter involved in the project. She also worked on the project for six months, but not full time. “It’s harder for beat reporters to break off and do something that requires that kind of concentration,” she says.
Shifting from daily coverage and weekly features to the project required her to re-read her notes often to refresh her memory, she says. She’d escape from her ringing phone by taking her notes to a coffee shop. “It takes more than a minute to get back in the loop,” she says. “I would write a lot of notes to myself about leads to pursue and people to call.”
Towards the end of the project, her editors hired freelancers and used wire copy so she could focus more on the project, she says.
Karen, who’s covered healthcare for 25 years, says working as a team allowed her to tackle a question she’d considered: How do hospitals make money when they say Medicaid and Medicare don’t cover their costs?
“With the three of us, we could get to a place to figure it out,” she says. “Alone, we’d be thrashing around to figure out where to go and what to look at. It helps to have partners to talk it over with and ask questions.”
Ames says it helps to team investigative reporters with beat reporters who know the issues and key sources. “If Karen had not been working on the this project, I don’t think we would have gotten interviews with key hospital officials, such as Carolinas HealthCare System CEO Mike Tarwater,” he says. “Karen’s sources and expertise added crucial depth to our stories.”
Partnering between the sister papers was nothing new. David worked with another Observer reporter while doing this project. Joe says he knew Ames already from various reporting events and from sharing tips. However, they’d never worked with each other before.
It also helped that they’d all worked on team projects before. “This one worked very well. Everyone was generous with sharing notes from every phone call and interview to get up to speed on what everyone else knew,” Karen says.
Like all projects, communication was key. As noted in my previous interview with Joe, the team posted files on Google Docs and DocumentCloud, and shared information through their common computer systems.
Ames says he also wrote story drafts and memos to summarize the important findings. “It’s a continual reminder about what you’re learning for your colleagues and editors,” he says.
They also bought their editors into the process. Jim Walser, the Observer’s senior editor for investigations, tagged along on interviews with hospital officials, Karen says. It allowed him to hear directly what sources were saying, and it showed newspaper was serious about the project, she says.
Aside from the editing process to ensure both papers had the same facts, the next challenge was finding people, Joe says. “A lot of people don’t want to speak ill of their doctors or hospitals,” Joe says. “There’s also a stigma about sharing medical information with the world.”
David says he searched a database listing all civil suits in North Carolina for cases involving hospitals. “We uncovered every kind of possible variation we could think of,” he says.
They also searched consumer complaints filed with the attorney general’s office.
Joe suggests reporters find patients early in the process and to ask them for itemized bills from hospitals. “Insurance companies don’t give much information on the explanation of benefits,” he says. “An itemized bill can show what everything costs.”
Motivation to keep going
As I noted in my post about B&S winner David Barstow, I’m curious about how reporters stay focused on lengthy projects. Here are the responses from this team.
Ames: “There’s a temptation to want to see your name in the paper a lot. But it’s helpful for reporters to remember that sometimes keeping focus on a project for a longer period will yield a much bigger dividend.”
Karen: “What motivates me is just that curiosity to know and understand how all of this works.”
David: “You’ve just got to tackle it and know there’s an end near.”
Joe: “Knowing we had to get it into the paper at some point. Near the end, I had been so immersed in this that none of it seemed new anymore. When we went through the first rounds of edits, I thought, ‘Doesn’t everybody know this?’” But he says when his executive editor read the story and said it “would piss off more people than anything we’ve ever done,” he knew the impact.
And he was right. When I spoke to Ames in April, he said the series generated more feedback than anything the paper had published in the past 10 years.