Association of Health Care Journalists Issues Commentary: Follow the Money – Uncovering Insurers' Confidential Clauses That Hit Patients in the Pocketbook

COLUMBIA, Missouri, May 22 -- The Association of Health Care Journalists issued the following commentary on May 21, 2024:

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Follow the Money - Uncovering Insurers' Confidential Clauses That Hit Patients in the Pocketbook

By Joseph Burns

New York Times investigative reporter Chris Hamby and STAT reporter Bob Herman, who covers the business of health care, were featured in a May 21 webinar on how journalists can report on the hidden and lucrative alliances health insurers have with cost-containment companies, pharmacy benefit managers (PBMs) and employee benefits consultants. The webinar was the second in a collaboration between The Association of Health Care Journalists and Investigative Reporters and Editors (IRE) and was offered as part of the organizations' "Follow the Money" series, with financial support from NIHCM.

In April, Hamby reported that MultiPlan, a company in New York City that helps health insurers keep costs down, and its health insurer clients have a large and mostly hidden financial incentive to cut payments for policyholders' claims as much as possible. The result can be patients paying more than they would otherwise.

After doing a year-long investigation, Herman reported last year on a largely hidden flow of money among employee benefit consulting companies, PBMs and health insurers. Those funds went from PBMs and health insurers to the benefit consulting companies, driving up health care and prescription drug spending for employers, workers and their families, Herman wrote.

During this webinar, hosted by AHCJ health policy beat leader Joe Burns, Hamby and Herman discussed the tools and outlined the tips and strategies they used to uncover these hidden agreements and how all health care journalists can report on this important story.

Joseph Burns is AHCJ's health beat leader on health policy and insurance. He's an independent journalist based in Brewster, Mass., who has covered health care, health policy and the business of care since 1991. Burns has written for a variety of publications, including The New York Times, Fortune, Hospitals & Health Networks, and Medical Economics, among others.

Chris Hamby is an investigative reporter at The New York Times. While working at the Center For Public Integrity, Hamby won the 2014 Pulitzer Prize for Investigative Reporting for his series of stories on coal miners and was later awarded the Lukas Prize to develop his reporting into a book. He was also a finalist for the 2017 Pulitzer Prize for International Reporting for his work on multinational corporations and their violations of domestic regulations and environmental law. He lives in Washington, D.C.

Bob Herman is a business of health care reporter at STAT. He covers hospitals, health insurance, and other corners of the industry -- with a goal of explaining and shining light on the massive amount of money flowing through the system. Prior to joining STAT in 2022, he covered the health care industry at Axios for more than five years. He also previously was an editor and reporter covering health insurance and hospitals at Modern Healthcare. Bob and his family are based in Indiana, so naturally he has a deep love for all things basketball.

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Original text here: https://healthjournalism.org/blog/2024/05/follow-the-money-uncovering-insurers-confidential-clauses-that-hit-patients-in-the-pocketbook/