Nieman Foundation at Harvard
Indian journalists are on the frontline in the fight against election deepfakes
ABOUT                    SUBSCRIBE
Sept. 21, 2017, 9:27 a.m.
Reporting & Production

“The Internet hates secrets”: Clear Health Costs works with newsrooms to bring healthcare costs out of hiding

“We think of this as a perfect use case for journalism — finding real, good information and displaying it back to the public.”

“The voicemails would make you want to cry.”

When New Orleans’ WVUE Fox 8 News invited viewers to get in touch and share their healthcare costs, they weren’t sure what kind of response they’d receive. Would people be willing to dig up the explanation-of-benefits forms they’d received from their insurance companies? Would they be okay sharing what they paid for colonoscopies, MRIs, routine blood tests?

As it turned out, not only were people willing — they leapt at the chance to participate in this crowdsourced investigation into healthcare pricing in New Orleans. The partnership between WVUE Fox 8, and The Times-Picayune, and Clear Health Costs drew thousands of responses through emails, form fills, letters, and voicemails — resulting in a package of stories that shed light on shady billing practices and help patients save money.

Clear Health Costs, based in New York, aims to bring more transparency to the healthcare marketplace by publishing the prices that people pay for medical procedures. The range is huge: The same kind of blood test cost $19 at one New Orleans lab, and $522 at a clinic a half block away. The same price discrepancies exist around the country. The company launched in 2010 with grants from the CUNY Graduate School of Journalism’s Entrepreneurial Program, the International Women’s Media Foundation, and the McCormick Foundation’s New Media Women Entrepreneurs Program. A series of early partnerships with WNYC, KQED in San Francisco, and others helped prepare it for the big New Orleans partnership this year.

“Healthcare pricing is opaque and there’s information asymmetry all over the place,” said Jeanne Pinder, the founder and CEO of Clear Health Costs. “The providers and insurance companies know the prices, but the patients know nothing. When you see an opaque marketplace like that, you can tell that people are making money off it. We think of this as a perfect use case for journalism — finding real, good information and displaying it back to the public.”

Fox 8,, and The Times-Picayune put out the call for New Orleans residents to share what they’d paid for medical procedures — via a Clear Health Costs widget on their websites, a voicemail line, and email. They explained how to read an insurance company explanation of benefits form. The cross-platform (website/newspaper/TV) nature of the partnership meant that older people with little knowledge of the Internet, or people without regular Internet access, could and did participate: Lee Zurik, Fox 8’s chief investigative reporter and news anchor, is a local star who’s won a number of awards, including a 2016 IRE award for his “Medical Waste” investigation.

“People who have TV and not Internet would call in and say things like, ‘I’m not privy to the Internet, but I have these bills here, how do I get them to you?'” Pinder recalled. “Or, ‘I saw Lee Zurik on TV and I have to talk to Lee because I have a problem.’ We were inundated by people who had stuff that they wanted us to know.”

“The voices really showed the emotion and helped tell the story of the healthcare system and where it needs to improve,” said Zurik. “We expected a lot of interest, but I don’t know if we quite expected the amount of communication we received.” Fox 8 had to reposition employees, moving them off their existing jobs temporarily to help handle the flow of information and return calls.

In addition to the crowdsourced data, Clear Health Costs also collects data itself. Its team members call hospitals and health clinics to get the prices of different procedures, including cash prices for those without insurance. “Clear Health Costs did that extremely laborious, tedious reporting that would otherwise have taken Lee and me a month of effort, if not more, and would have taken us away from our daily reporting demands,” said Jed Lipinski, who was crime and public health reporter at at the time of the project. Having some data available at the start of the project — data that already showed massive price disparities between identical procedures at different hospitals — “allowed us to get the ball rolling immediately and generate some anger in the community; we had really juicy stuff to get the public interested.”

Clear Health Costs is a for-profit company. (It was founded out of Jeff Jarvis and Jeremy Caplan’s entrepreneurial journalism class at CUNY; Jarvis didn’t want students to create nonprofits. The program has since grown into the Tow-Knight Center for Entrepreneurial Journalism.) Its news partners pay it to collect data and set up the crowdsourcing widgets for their specific projects. CHC also maintains the collection module’s backend and consults with the news organizations on what the data means and how to create the best journalism out of it. “I’m essentially a domain-expert freelancer, as part of our agreement with them,” said Pinder, who previously worked at The New York Times for 23 years.

Moving forward, Pinder hopes that Clear Health Costs that won’t cost newsrooms anything. Since the New Orleans project, she’s heard from businesses asking to advertise on Clear Heath Costs and has invited them to become sponsors of collection projects in specific cities. For instance, Clear Health Costs is in discussions with, a sister publication of within the Advance chain, about one such partnership that would be underwritten by a sponsor. CHC has also received requests to buy its data, “which we think of as a very worthy and perhaps much more remunerative business model,” Pinder said.

In addition to being a lot of work, projects like the New Orleans partnership are also a heavy emotional lift. “It’s a delicate balancing act, not to get too wrapped up in the emotional lives of people who are victimized,” said Lipinski. “I took this as an opportunity to use their emotion and their anger and their sadness to fuel some of the difficult reporting we were doing.” Journalists probably aren’t going to be able to solve individual people’s problems, Pinder said — but she believes they can connect people with those who can. She envisions events, for instance, where people would bring in their medical bills and be connected with consumer health organizations for assistance — “a way we can say to people, ‘We’re here to help, we’re not just here to shine a spotlight on you.'” The reporting produced in New Orleans also includes concrete tips on topics like how to argue medical bills and 10 questions to ask. “We hope they will get back to us and tell us what it feels like. We know there’s a deeper desire and need for something more solutions-y, more robust.”

There is also, of course, opaque pricing in plenty of areas besides healthcare — higher education, mortgages. “There’s opportunity in big, closed marketplaces where people think, ‘Well, it’s always going to be that way,'” said Pinder. “With the tools of journalism, and with the Internet, we can change that. The Internet hates secrets.”

Photo of a hospital bill from 1946 — nine bucks a day for hospitalization! — by Heather used under a Creative Commons license.

Laura Hazard Owen is the editor of Nieman Lab. You can reach her via email ( or Twitter DM (@laurahazardowen).
POSTED     Sept. 21, 2017, 9:27 a.m.
SEE MORE ON Reporting & Production
Show tags
Join the 60,000 who get the freshest future-of-journalism news in our daily email.
Indian journalists are on the frontline in the fight against election deepfakes
The ongoing general election is a pressure test for how to report on political voice clones and video spoofs.
Welcome to the neighborhood! How Documented brings NYC immigration news to Nextdoor’s Caribbean communities
“We are bringing onto this platform — where people usually talk about their lost cat or that they’re looking for an apartment — serious news content sparking a new kind of conversation.”
ProPublica’s new “50 states” commitment builds on a decade-plus of local news partnerships
With annual revenue of $45 million and a staff approaching 200 people, ProPublica has been one of the big journalism winners of the past decade. And it’s been unusually willing to spread that wealth around the country.