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Colorado journalists show power of collaboration in UCHealth debt collection exposé

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Colorado journalists show power of collaboration in UCHealth debt collection exposé


University of Colorado Hospital. Photo by Jeffrey Beall (CC BY-SA 3.0)

In June, Colorado Gov. Jared Polis signed into law HB24-1380, Regulation of Debt-Related Services. The law marked a milestone in a five-year investigation by a group of reporters into the debt-collection practices of the University of Colorado Health System (UCHealth).

Starting in 2019, journalists from five news outlets collected data on the number of lawsuits UCHealth brought against patients who had unpaid medical bills, according to reporting from Chris Vanderveen, the director of special projects for television station 9News, and John Ingold, a health reporter and cofounder of the nonprofit news outlet, The Colorado Sun.

Dubbed “Diagnosis: Debt Colorado,” the reporting project stems from a partnership led by the Colorado News Collaborative (COLab) and KFF Health News and included contributions from The Colorado Sun, 9News, Colorado Newsline and The Sentinel. In a series stemming from KFF Health News’ reporting on medical debt in the United States, the reporters explored the causes, scale and effects of medical debt on Colorado’s residents.

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UCHealth is the state’s largest hospital system, collecting more than $6 billion in patient care revenue annually, Ingold and Vanderveen reported on Feb. 19, “UCHealth sues thousands of patients every year. But you won’t find its name on the lawsuits.”

In its mission statement, UCHealth says, “We improve lives,” the reporters noted. But from 2019 through 2023, the health system and its debt collectors filed 15,710 lawsuits, UCHealth revealed in response to questions from Ingold and Vanderveen, the two reporters wrote in that Feb. 19 article. That’s an average of 3,142 lawsuits per year, or more than eight per day, they noted. Yet almost none of the lawsuits were filed in UCHealth’s name, they added.

In a broadcast on June 27, Vanderveen summarized the reporters’ findings. “As Colorado’s largest and most prominent medical provider insisted it was ‘not hiding anything,’ an exhaustive investigation discovered UCHealth, for years, used what amounted to a loophole in the state’s court system to keep private its aggressive bill collection practices,” Vanderveen wrote.

While journalists often cover hospitals’ confrontational billing and collection tactics, the investigative work of Vanderveen, Ingold and other journalists in this collaboration is significant because it shows how health reporters can uncover lawsuits when a hospital or health system conceals its legal actions against patients.

For their work, the collaborative efforts were particularly useful as were more traditional reporting strategies: soliciting patients’ hospital bills over multiple years, visiting courthouses when debt-collection cases were heard, and gathering the names of defendants and lawyers in those cases.

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This spring, the investigation prompted the Colorado General Assembly to pass HB24-1380 to close a loophole that allowed UCHealth to sue thousands of patients under another business’ name, Vanderveen reported. Starting this fall, the law will force hospital systems to sue patients under their own names on debts the systems still own.

After the legislature passed HB24-1380, state Sen. Sonya Jaquez Lewis, praised the journalists’ work. “I really do think we owe you a little bit of thanks — maybe a lot of thanks and gratitude — for sure, because it pointed us in the right direction,” said Jaquez Lewis, a sponsor of the bill.

How the project unfolded

Early in 2020, UCHealth ended its years-long practice of suing patients under its own name, a change that was not disclosed to the state legislature or the public, Vanderveen reported. “The decision allowed UCHealth to continue to sue patients — roughly eight per day for years — with virtually no way to track its legal efforts,” the TV station explained. By allowing two of its third-party debt collectors to use their names as plaintiffs, “UCHealth turned a once-transparent process into a confusing and opaque mess for many of its patients,” the news station added.

When journalists asked about the issue, UCHealth’s administrators said the health system had sued more than 15,000 patients in five years, becoming one of the most aggressive litigants in Colorado, 9News explained.

Soliciting data from patients’ bills

Years before collaborating with other journalists to report on medical debt, Vanderveen asked 9News’ viewers to send in their medical bills. “Sometime between 2016 and 2018, we started a bill-solicitation program called, ‘Show Us Your Bills,’ and we got a lot of submissions,” he said in a phone interview. From those bills, Vanderveen built a database showing how often each hospital filed lawsuits, including the most aggressive litigants.

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In 2020, COVID-19 forced all health care journalists to postpone their regular work, but later that year, Vanderveen became curious about how many hospitals filed debt-collection suits during the pandemic. His data showed a sudden drop in lawsuits from UCHealth.

Also in 2020, two Kaiser Health News journalists — senior correspondent Jay Hancock and data editor Elizabeth Lucas — were Pulitzer Prize finalists for reporting in 2019 on the predatory billing practices of the University of Virginia Health System. In an eight-part series, Hancock and Lucas exposed how UVA “relentlessly squeezed low-income patients — many into bankruptcy — forcing the nonprofit, state-run hospital to change its tactics,” the Pulitzer prize committee wrote, as AHCJ reported in a tip sheet published that same year.

Did UVA’s experience prompt UCHealth to change its tactics? Vanderveen wondered. “On the surface, it appeared as if UCHealth had a change of heart because no more lawsuits were filed under UCHealth’s name,” he explained. “It went from about hundreds per quarter to like two or three per quarter.” About that same time, he heard about Credit Service Co., a debt collector in Colorado Springs, that was a party to some UCHealth lawsuits against patients, he said. [See image from 9News.]

A trove of data in court filings

As Vanderveen’s data showed, UCHealth never stopped suing patients in early 2020. While it didn’t do so in a publicly traceable way, he could still find cases by searching court records for Credit Service Co. as a plaintiff, he said.

Visiting the courthouse was also useful, Ingold added. “Going to court is something I would highly recommend, because your local jurisdiction is probably hearing many debt-collection cases on the same days,” he said. “Plus, the lawyers who handle those cases are all the same people.” These courts had long dockets of cases that debt collectors filed, he noted. 

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Inside Colorado’s courts, the reporters found defendants waiting to respond to debt-collection summonses. “Chris [Vanderveen] would walk up and down a row of people, and ask, ‘Who’s here for a UCHealth case,’ and ‘Who’s being sued by the Credit Service Company?” Ingold said. Several defendants raised their hands, he noted. At the same time, Ingold found people named in suits that other health care entities brought, leading to more stories.

In addition, the reporters called legal services groups, consumer assistance programs, law school clinics and any other organization helping consumers, especially those with low income, Ingold said. They would have at least some insight into who is suing over medical debt.

Another reporting strategy is to seek defendants who filed answers to complaints, meaning the case may go to a hearing or trial, Ingold advised. In those case files, reporters may find creditors’ names, he said. Also, defendants who challenge these cases may want to talk to reporters, he added.

The value of collaboration

One of the most important lessons learned was the teamwork that came from the collaborative nature of the project. At COLab, journalists no longer compete as they once did to be the first to break stories. Instead, COLab journalists from different newsrooms work on projects together to serve the public good, Ingold explained.

“What we produce for the news collaborative can be distributed to pretty much any newsroom in Colorado that wants it,” he added said. “My story about the lawsuits ran on our site, at www.ColoradoSun.com, and it ran on the websites of the other news collaborators. Also, it ended up in The Denver Post and a number of other places around the state.”

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COLab makes efficient use of the limited staff left behind in many newsrooms when fewer news outlets can devote multiple staff to any one project, he commented. “Also, we can help all the participating newsrooms by providing content everybody can use,” he added.

In addition to working with multiple newsrooms in Colorado, COLab also worked with Noam N. Levey, a senior correspondent at KFF Health News, who has led KFF’s award-winning project, Diagnosis: Debt.

Levey introduced the Colorado reporters to the staff at the Urban Institute who have researched how medical debt and collections affect immigrants and people of color, said Tina Griego, COLab’s managing editor. Data from the Urban Institute led to this story, “Medical Debt Affects Much of America, but Colorado Immigrants Are Hit Especially Hard,” by Rae Ellen Bichell and Lindsey Toomer, of Colorado Newsline, Griego explained. Bichell is a Colorado correspondent for KFF Health News and Toomer covers politics and social justice for Colorado Newsline, which is part of the States Newsroom, a nonprofit covering state capitals.

Resources

  • “UCHealth sues thousands of patients every year but doesn’t use its own name to do it,” Colorado Sun and 9News, Feb. 16, 2024.
  • “Colorado hospital giant’s lawsuits fill county courtrooms with defendants and confusion,” 9News, March 1, 2024.
  • “Medical Debt Affects Much of America, but Colorado Immigrants Are Hit Especially Hard,” April 3, 2024.
  • “Hospitals suing patients over unpaid bills would have to put their names on lawsuits under new Colorado measure,” Colorado Sun, April 12, 2024.
  • “Loophole allowed UCHealth to sue thousands of patients under another business’ name,” 9News, June 27, 2024.



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1up Arcade Bar in LoDo pulls the plug as owners prep Lakewood location

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1up Arcade Bar in LoDo pulls the plug as owners prep Lakewood location


It’s game over for Colorado’s first arcade-bar as The 1up LoDo pulls the plug on its pinball machines and video game cabinets for the last time.

The spot, which billed itself as the first of its kind in the state, ceased operations on Monday, June 22, in anticipation of a 13,000-square-foot 1up location opening in Lakewood’s Belmar development.

“Our new home will occupy the former Lucky Strike space, at 415 Teller St. in Lakewood, and preserve much of the underground atmosphere that made the original LoDo location so memorable,” the owners wrote on Facebook on Monday. “It will be the largest 1up Arcade Bar we have ever built and will feature our most extensive collection of arcade games, pinball machines, redemption games, and attractions to date.”



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The Colorado River is vanishing — and the fixes are getting weird

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The Colorado River is vanishing — and the fixes are getting weird


The crisis on the Colorado River is simple: The seven Western states that border the essential waterway use more water than it contains. Chronic overuse has drained its two largest reservoirs, Lake Powell and Lake Mead, and a two-decade drought cycle has pushed them to the point of collapse. 

The dream solution to this crisis is an agreement among all involved to use less water. Such a deal would decide who must reduce consumption, which means asking which cities would ban irrigating lawns and washing cars and which farmers would rip up their fields.

This has proven impossible. The states have been trying to work this out since the last dry spell, in 2022, but talks have ended in frustration and name-calling. The main sticking point is between the “Upper Basin” states led by Colorado and Utah (along with Wyoming and New Mexico) and the “Lower Basin” states of Arizona, California, and Nevada. Each side believes the other has a legal and a moral responsibility to cut usage during dry years. The stalemate means the Trump administration must design a schedule of restrictions ahead of a crucial deadline in September. So far, Interior Secretary Doug Burgum has balked at resolving the quarrel.

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Instead, the administration is turning to a far less controversial plan: Throw money at the problem. The Interior Department and Congress are pondering a slew on projects that could increase supply, a reversal of Trump’s zeal for cutting federal grants. The seven state governors have sent Washington a “wish list” of over $50 billion, and several startups have their hands out as well.

Federal investment makes sense given the scale of the problem and the intractable impasse, said Jennifer Pitt, the Colorado River program director at the National Audubon Society and an expert on the governance of the river

“It is something easier for people to agree on,” she said. “This is a slow moving crisis, but it is a crisis, and we do see the federal funding come in to address crises in other parts of the country. Just because this is a slow moving one doesn’t make it any less worthy.”

During a Senate committee hearing last week, the Interior Department’s top water official, Andrea Travnicek, said the agency has yet to vet the wish list. She didn’t offer a specific funding request, and urged lawmakers to be “thoughtful” about how they spend taxpayer money. But senators of both parties seemed to encourage new investments. “The basin should not be forced to choose between stabilizing the present and negotiating the future,” said Senator Martin Heinrich, a Democrat from New Mexico.

The possibility of new funding marks a return to the policy of the Biden administration. During the last extreme drought in 2022, the Interior Department paid farmers billions to leave their fields fallow, but that money, from the Inflation Reduction Act, has almost run dry. 

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The difference now is that the roster of proposals is far more ambitious, and some far less certain to bolster the basin’s water supply. They range from desalination plants to desert groundwater pipelines to forest ecosystem restoration.

Here are a few of the major solutions state officials and companies are proposing.

Spending $6 billion to build another facility like the Carlsbad Desalination Plant is among the proposed solutions to the water crisis. Nelvin C. Cepeda/The San Diego Union-Tribune via Getty Images

Desalination

As the Colorado River crisis has deepened, some cities in the Southwest have eyed desalination, which extracts salt from sea water. A company called Poseidon Water opened such a plant in San Diego in 2015, and tried for decades to open another in Los Angeles. The wish list to Interior requests as much as $6 billion to build one in Baja California to supplement Arizona’s vanishing Colorado River supplies.

The Interior Department also signed an agreement in early June with San Diego’s water agency that explains how that plant would help. Rather than sending treated seawater inland, states would pay the city to take less from the Colorado River. Arizona stands to lose the most water during drought years, and it would be the most likely to participate in that exchange.

But desalination is expensive, requires enormous amounts of electricity, and state-of-the-art industrial technology. The Poseidon facility cost $1 billion, but San Diego has diversified its water portfolio so much that it no longer needs all the water it must purchase from the plant. Trading water could help it offset some of that cost. 

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Taming tech and power

Nevada uses less water than any state on the river, and has cut usage in Las Vegas by replacing grass with artificial turf. It is now seeking money to slake some of its last thirsty industries — power plants and data centers. These facilities need a fraction of what agriculture requires, but dominate usage in The Silver State.  

The state’s wish list includes $300 million to retrofit its largest natural gas plant and reduce water consumption by an amount equivalent to more than 3,000 average homes. It also seeks $650 million to install zero-water cooling systems in its airports, schools, and industrial facilities. These closed-loop systems, which recirculate the same cooled water or, in the case of data centers, blast hot servers with cold air, have become more popular in Western states amid concerns about the tech boom’s growing thirst.

A man signals to another man to fire a seed-clouding rocket.
A Chinese worker fires rockets for cloud seeding effort in Huangpi, China in 2011. There are similar calls to do so in the United States to help restore the Colorado River.
CN-STR / AFP via Getty Images

Squeezing rain from the clouds

Whereas Lower Basin states like Arizona and California can draw from the Colorado River’s big reservoirs on demand, northern states at its headwaters only receive the rain and snow that feed it. 

These Upper Basin states have been trying for decades to engineer more precipitation, with support from Washington. It sounds futuristic, but cloud seeding — spraying salt or silver iodide into clouds, forcing them to release water they might otherwise retain — has proven fairly effective on a small scale. Utah spends a few million dollars each year doing this, and officials say it could boost annual snowpack by as much as 10 percent. 

In addition, a few startups are pitching cheaper and more scalable versions of this technology. Rain Enhancement, a Florida-based outfit, says it has brought about 15,000 homes’ worth of rain to a river tributary in Utah this year; another, Rainmaker, says it can produce 1,000 times that much by 2031. That’s enough to close the supply gap on the river. That promise is fanciful, but these companies could secure federal funding from an administration that loves the tech industry.

Mining a hoard of desert groundwater

The West teems with companies that have promised miracles, from building a 300-mile pipeline to tapping a hoard of groundwater in Nevada. But perhaps no project has had a longer and more turbulent history than Cadiz, a proposal, almost 30 years old, to export groundwater from an aquifer in the Mojave Desert.

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This has drawn vicious opposition from environmentalists and the late California Senator Dianne Feinstein, who called it a “grave threat” to the desert. Cadiz experienced several setbacks during the Biden administration: It lost a federal permit, California ended its pipeline lease, Arizona declined to support it, and its stock price fell to almost zero. But Susan Kennedy, its CEO, says Cadiz is flowing again with a funding agreement from the Interior Department to study exchanges between Cadiz and the Colorado River.

The company still needs to finish two pipelines, one to the Central Valley and another to the aqueduct that carries Colorado River water to California. It also must build a plant to remove contaminants in the water, but Kennedy believes she can have the tap running by 2028.

“This isn’t a competition, it’s an all-of-the-above situation,” she said of the situation on the river. That may be so, but the seven states did not include Cadiz on the “wish list” sent the Interior Department.






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Northwest Colorado state parks experiencing water shortages, reduced boating access

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Northwest Colorado state parks experiencing water shortages, reduced boating access


Impacts from Colorado’s extreme drought conditions are hitting several state parks in the state’s northwest corner. 

Colorado Parks and Wildlife announced emergency water conservation measures and boating restrictions at both Sylvan Lake State Park in Eagle County and Rifle Gap State Park in Garfield County, according to a Monday, June 22 news release. 

Both parks are located within some of the more extreme drought conditions in Colorado. According to the June 18 U.S. Drought Monitor, Eagle County and western Garfield County are experiencing exceptional drought conditions — the worst measured by the monitor.  



Sylvan Lake State Park

At Sylvan Lake State Park outside of Eagle, the park’s main source and well, Zurcher Spring, has run completely dry and shows no signs of recovery due to the extreme drought conditions in the region. 

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To maintain basic operations at the park, Parks and Wildlife has transitioned to using a secondary water source, Cowboy Spring. This spring is producing 2,000 gallons of water per day, and with park usage ranging between 2,500 and 3,000 gallons daily, park staff shut off all 17 public water spigots in the state park. 



“We are using more water than we can currently produce, and are on track to run out,” said Sylvan Lake State Park Manager Matt Westerberg in the news release. “We know turning off the water spigots isn’t ideal, but our hope is this will save enough water to keep the main campground shower building operational for visitors.”

Despite having a workaround, Parks and Wildlife is asking visitors to help out by bringing their own water. Visitors can fill their tanks at the visitor center, which operates on a separate, functioning well system. 

Rifle Gap State Park

A little further west in Garfield County, Rifle Gap State Park is experiencing impacts brought on by the winter’s historically low snowpack and early snowmelt. While the park typically experiences water declines in the late summer, they are hitting the state park months ahead of schedule, Parks and Wildlife reported. 

To combat this, Parks and Wildlife is reducing motorized boat launching to a single lane and has pulled all courtesy docks from the water. Access for hand-launched vessels like kayaks, canoes and stand-up paddleboards will remain unaffected by the closure.

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“With our boat ramp down to a single lane, launching and loading will take significantly longer than usual,” said Rifle Gap State Park Manager Brian Palcer in the release. “We are asking all boaters to practice patience, pack an extra dose of courtesy for their fellow recreators at the ramp, and expect delays. We want everyone to have a safe, enjoyable day on the water despite these challenging conditions.”

Parks and Wildlife encourages boaters to exercise caution as low water levels have also exposed shallow, unmarked hazards across the reservoir, including uneven bottom topography, fish habitat structures, rocks and tree stumps. With these conditions, the agency also issued a reminder that life jackets are required on all vessels.  

If the reservoir continues to recede at its current rate, Parks and Wildlife said the water levels will drop entirely below the concrete boat ramp, forcing a complete closure of the ramp to motorized watercraft for the remainder of the season in early July.

At both parks, the most current information can be found on their individual Facebook pages and websites on CPW.State.CO.US/state-parks





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