By Chris Adams

Paying for health care is one of the most important things the federal government in Washington does: One in four federal dollars flows through the Department of Health and Human Services, which also gives out scientific and medical grants to researchers throughout the country.

How do you get a handle on such a massive beat? And how do you get the data and detail that can move a story from the realm of talking heads and anecdotes to something that is authoritative?

Two journalists from Kaiser Health News – a Washington-based outlet that produces original content on health care policy and serves as an aggregator of health care stories from across the country – offered practical and detailed presentation to journalists.

Figuring how money flows out of Washington has been something Mary Agnes Carey had done during a long career, most recently as an editor and correspondent at Kaiser. Among Carey’s sources:

--The Health and Human Services inspector general, which recently put out its work plan for 2016, details a range of waste, fraud and other topics it intends to investigate.

--Health Affairs, a journal that Carey said is surprisingly accessible and offers astute and understandable takes on the Affordable Care Act and other policies.

--The Medicare Payment Advisory Commission, which makes recommendations on spending proposals – and therefore where to possibly find fat in health spending.

--The Bipartisan Policy Center, where former members of Congress and others analyze health policies and legislation.

--Former Health and Human Services secretaries or former Centers for Medicare and Medicaid Services administrators, who will get on the phone and talk with reporters in a way they were hesitant to – or simply didn’t have the time for – while in office.

Jordan Rau, a senior correspondent for Kaiser, regularly incorporates major databases into his work. And whenever he gets hold of a new set of data, he treats it as he would any source and ticks off five questions to “ask” of it.

  1. What’s the source? Or, basically, where do the data come from? Rau, an accomplished expert on health- care data, often gets information whose initial source was patient billing records, or clinical charts, or perhaps patient surveys.
  2. Who is included? A population of patients of all ages would be very different than one of just Medicare ones.
  3. What time period is covered? Unfortunately, he said, a major problem with a lot of health data is that there’s a big lag before it’s available.
  4. Are the differences statistically meaningful?
  5. And finally, a very important one: Is it risk-adjusted? After all, a high death rate in a hospital that mostly treats complicated cases and rare illnesses will mean something different than the same death rate at a community hospital.