2022 The University of Florida Award for Investigative Data Journalism, Large Newsroom finalist

Secret Prices, Questionable Tests: Using Data to Investigate Medical Care

About the Project

In a series of data-driven articles, the New York Times correspondent Sarah Kliff and several of her colleagues revealed disturbing examples of powerful health care companies’ charging exorbitant amounts for care — sometimes, of dubious value.

With the reporter Josh Katz, Ms. Kliff showed how hospitals have exploited the secrecy of their prices to charge wildly different amounts for the simplest services — and how major insurers bolstered their profits by letting it happen, at the expense of the patients and employers who were paying the insurers to negotiate on their behalf.

With the reporter Aatish Bhatia, Ms. Kliff showed how prenatal tests that can cost patients as much as $4,000 deliver surprisingly unreliable results. They found positive results on one line of tests were false positives 85 percent of the time. But misleading marketing by the testmakers — many of them trusted household names that could earn twice as much when the test was included — left a trail of terrified expectant parents across America, some of whom were pushed to the verge of terminating a pregnancy based on screening results that were later proved incorrect.

Ms. Kliff also revealed how Cigna pursued parents to recover more than $250,000 after their little girl died in a hospital — bills that the health insurer shouldn’t have paid the hospital originally. And she uncovered a lab that was brazenly charging hundreds of dollars more than the usual price for a rapid Covid test. Mr. Katz, Ms. Kliff and their colleague Margot Sanger-Katz also showed how the Food and Drug Administration’s questionable approval of the Alzheimer’s treatment Aduhelm risked costing the federal government more than some federal agencies’ entire budgets, which could raise taxes for everyone and push up premiums for seniors.

Their powerful and vivid journalism seized the attention of millions of readers and led to change. The grieving parents’ exorbitant hospital bill was canceled, and Cigna vowed to review its policies to prevent similar situations. The prenatal testing article led to a rare demand for regulatory intervention by Republican members of Congress. Manufacturers began removing misleading marketing before the piece was even published, and the F.D.A. issued a public warning about the tests to patients and doctors.

The rising cost of U.S. health care is one of the more important issues facing Americans, and Ms. Kliff and her colleagues repeatedly unearthed surprising revelations. Together, their work painted a clearer picture of how some of the biggest and most profitable companies in the country have benefited from the secrecy that surrounds what patients are paying, and the care they get in return.