Parkview Field in Fort Wayne, Indiana Parkview Health purchased the naming rights to the stadium for $3 million. Photo by Momoneymoproblemz, via Wikimedia Commons (CC BY-SA 3.0)
Last fall, three reporters at the Guardian reported how Parkview Health, Indiana’s largest hospital system, had been aggressively consolidating for more than a decade, moving patients into more expensive healthcare settings. He introduced how the company had become the region’s largest employer by securing high insurance premiums from medical insurance companies. A two-part series.It’s too big to worry about” featured the year’s best investigative stories.
The newspaper said: “‘Too big to care’ is a US study by the Guardian that examined how consolidation of the US health care system is subjecting patients to higher bills, fewer options and poorer quality care. There is,” he explained.
The three reporters are– george joseph, will craft and jessica grenza — how nonprofit hospital system Concentration in northeastern Indiana and northwest Ohio has driven up prices, hurting employers and consumers, and burdening patients with medical debt. Joseph is an investigative journalist, Kraft is a data editor for the investigative team, and Glenza is a health reporter.
The first of two Guardian articles reads:‘Unlimited Dollars’: How an Indiana hospital chain took over the region and jacked up pricesParkview Health is the largest employer in the small city of Fort Wayne. Population: 271,865.
The second article is “Patients, employers accuse Indiana nonprofit hospital of price gouging” published Oct. 24, Joseph cited opinions from Indiana lawmakers and Fort Wayne residents who are critical of the hospital chain’s high costs. “A chorus of Indiana employers, patients, and political leaders spoke out against Parkview Health,” he wrote.
High bills, few options, poor care
Coincidentally, two US articles in the Guardian corroborate the findings of a report published by the Urban Institute in the same month.Is hospital market concentration related to medical debt?The Institute’s report and Too Big to Care series show that reporting on hospital market concentration is an important story worth pursuing in places where hospitals are concentrated. are. For example, see this report from KFF.One or two health systems will control the entire market for inpatient care in nearly half of metropolitan areas by 2022”
In an interview with AHCJ, Joseph and Kraft said they spent more than three months interviewing 40 current and former Parkview employees, patients, business leaders, members of Congress, and competitors at other hospitals and conducting hundreds of interviews. He said he reviewed internal billing, policy documents and patient bills. For the second article, we interviewed over 11 sources.
“It’s outrageous that a nonprofit health system like Parkview can use its market power to force patients to pay higher costs,” Indiana Sen. Shelley Yoder told Joseph. “Hoosiers deserve better than going into medical debt just to get the care they need. Health care is not the privilege of a few. It is a right for everyone.”
Matt Bell, lobbyist for Hoosiers for Affordable Health Care, said the industry group will urge lawmakers to curb consolidation and limit high prices. The second proposal would prohibit hospitals from asking health insurance companies to curb their ability to direct patients to specific providers, and the third proposal would prohibit hospitals from asking private insurance companies to restrict their ability to direct patients to specific providers for the same services. It would penalize nonprofit hospitals that charge 260% more than they bill Medicare.
“Squeezing the life out of the local economy”
“For more than a decade, Parkview Health has demanded that people in northeastern Indiana and northwestern Ohio pay some of the highest rates of any hospital system in the country — headquartered now in Indiana. Located in Fort Wayne, the hospital is currently ranked number one in the world, “one of the most affordable metropolitan areas in the United States,” Joseph, Kraft, and Grenza wrote in their first article. I’m writing this.
These high fees have made Parkview Health a dominant hospital in Fort Wayne and are part of a more than 20-year campaign by hospital executives “to extract revenue from patients and employers who feel they have no better options.” The reporters added that this was the result. During this period, Parkview Health took over six former rival hospitals and built a network of approximately 300 locations for physicians and other health care providers.
For 10 of the past 13 years, Parkview Hospital has ranked among the top 10 most expensive hospitals in the country on average, according to an analysis of pricing data the hospital submits to the federal Centers for Medicare and Medicaid and Parkview Health’s billings. It turned out that it was in the %. Since 2019, Parkview Health has generated more than $2 billion in annual revenue, they reported.
Joseph, Kraft and Grenza said the broader integration will allow Parkview Health to control the flow of referrals by sending primary care patients to Parkview Health’s more expensive specialists and facilities. , wrote that Parkview’s influence in negotiations with health insurance companies has increased.
Semi-rural areas like Fort Wayne with relatively few health care providers are more susceptible to consolidation, according to a Yale University economics professor. zach cooperPh.D. “This is where you start to see 10% to 15% price increases over time.” Cooper said in the first article of the series.. “But what we’re starting to see is that a lot of the local health care systems are just strangling some of these local economies and squeezing lives.”
Prices soar due to secret negotiations
Joseph advised other journalists to pursue similar stories. “The area that was interesting to me and the most difficult to report on was the secret negotiations that occur every few years when insurance companies and hospitals negotiate contracts,” he said. “This is a vast area that any local reporter could delve into because of the paper trail. I read the bond documents and the Moody’s analyst report to understand the angle.”
Joseph added: “These behind-the-scenes negotiations determine prices for millions of people and employers, which means this is a very important issue to people’s lives.”
Last year, when Joseph, Kraft and Glenza were reporting on Parkview Health; RAND releases the fifth in a series of reports As AHCJ reported here, on how much employers pay hospitals. at that time, Reported by Whitney Downard Indiana Capital Chronicle Indiana has the eighth-highest hospital prices in the nation.
The Guardian reporter included the following data in his article: That RAND report This indicates that Parkview Health’s prices are the highest in the state compared to what Medicare pays. Despite the RAND data, there are few research reports on Parkview Health, Joseph said.
After article publication, Arnold Ventures Founder and Co-Chairman John Arnold comments on X (Formerly on Twitter) “High health care costs act as a tax and make the state less competitive. There is broad consensus that consolidation is hurting the state, and Governor-elect Mike Brown is calling for reform. Given the current situation, substantial action could be taken next year.”
And Arnold wrote that the stories were “a great example of the value of deep, investigative journalism.”
