The Reynolds Center for Business Journalism at Arizona State University announced today that ProPublica reporter Ava Kofman has won the 2023 Barlett & Steele Outstanding Young Journalist Award for “Endgame: How the Visionary Hospice Movement Became a For-Profit Hustle,” a collaboration with The New Yorker. Additionally, ProPublica’s reporting into health insurance denials, including collaborations with Capitol Forum, won Silver in the Global/National category. Named after the formidable team of investigative business journalists Don Barlett and Jim Steele, these annual awards honor “incisive business reporting that ‘tells us something we don’t know.’”
Half of all Americans die in hospice, and Kofman’s groundbreaking investigation prompted a national conversation on the American way of death — along with demands to reform an industry that has long been ignored. Kofman packed deep reporting and data analysis into an arresting legal thriller that exposed the way easy money and lax regulation have transformed a charity movement into a $22 billion juggernaut rife with exploitation.
Less than three weeks after the expose was published, a bipartisan group of senators sent a letter to the Department of Health and Human Services requesting the agency “immediately investigate the situation.” In January, the Centers for Medicare and Medicaid Services reformed how they inspect hospice providers. In hearings this March, the Senate Finance Committee and House Ways and Means Committee pressed HHS Secretary Xavier Becerra to stop the hospice profiteering uncovered by the article. In July, federal regulators rolled out enhanced oversight of new hospices in Arizona, California, Nevada and Texas, targeting providers highlighted by the investigation.
In the “Uncovered” series, ProPublica and The Capitol Forum exposed the inner workings of health insurers and their process for denying care to the people covered by their plans. Reporters obtained internal documents, audio recordings, emails, physician reports and other records to show how big insurers reject requests for payments of care that they deem not “medically necessary” and how medical directors reject claims with little or no review of patient records. The publications revealed how Cigna built a system that allows its medical directors to instantly reject a claim on medical grounds without even opening the patient file, leaving people with unexpected bills. Over a period of two months, Cigna doctors denied more than 300,000 requests for payments using this method, spending an average of 1.2 seconds on each case. In May, a congressional committee and government regulators began scrutinizing Cigna following the investigation. And in July, a California law firm filed a class-action lawsuit against the company, citing our reporting as the basis for the action, alleging that Cigna violated a state law requiring insurers to conduct a “thorough, fair and objective” investigation of patient claims for medical care.
ProPublica also exposed the unregulated world of health care sharing ministries, religious nonprofits that operate like health insurance providers, where members of a church or larger faith community pay monthly fees and the organization pays their health care bills. Liberty HealthShare, the nation’s largest such ministry, was founded by members of the Beers family of Canton, Ohio, who had a long and well-documented history of fraud. With thousands of members complaining about being denied payments for their bills last year, ProPublica reporters Ryan Gabrielson and J. David McSwane began examining Liberty and the small group of relatives and close friends that ran it. The investigation found that Liberty’s executives drove members into debt and financial ruin while the company paid more than $140 million to businesses owned and operated by Beers family members and friends. The family then funneled the money through a network of shell companies to buy a private airline in Ohio, more than $20 million in real estate holdings and scores of other businesses, including a winery in Oregon that they turned into a marijuana farm and a bank in the Missouri Ozarks.
View the full list of winners.