The Caitlin Clark era in the WNBA has officially begun, although it got off to a slow start.

Clark went scoreless in the first quarter of the Indiana Fever’s game against the Connecticut Sun on Tuesday night. She missed her first four shots before finally getting on the board midway through the second period.

The NCAA’s all-time Division I scoring leader stole the ball around the foul line and drove the length of the court before laying the ball in. Clark had said before the game that she thought her first basket would come on a layup since it was a “high-percentage” shot.

She probably just didn’t think it would take nearly 15 minutes for it to happen.

Clark later added two free throws and hit a three-pointer with 29.9 seconds left in the first half to finish the opening 20 minutes with seven points, hitting two of her seven shot attempts.

The Fever went on to lose 92-71 to the Sun as Clark offset her team-high 20 points with 10 turnovers.

Before her first basket, Clark struggled and got into early foul trouble. Her first shot was a drive to the basket that bounced hard off the glass and into Aliyah Boston’s hands for a putback. Clark missed a runner in the lane, and then her 3 from the left wing just rimmed out. She did have an assist on one basket and threw a nifty behind-the-back pass to teammate Boston, but last season’s Rookie of the Year was called for a traveling violation.

Meanwhile, Clark was called for two fouls on the defensive end. The second one drew loud boos from the sellout crowd. The crowd gave the No 1 pick in the draft a loud ovation when she was announced in the pregame introduction.

Before the game, Clark admitted she was eager for her WNBA debut. It was one of four games on the league’s opening night to tip-off the WNBA’s 28th season. New York, which was runner-up in the WNBA Finals, visited Washington to start the evening.

She sat around most of the day at the hotel and had to wait to get on the court when her team arrived nearly 2:30 hours before tipoff.

“I just want to get out there and play,” she said. “I got plenty of time to sit and think about it. Still this is exciting. This is fun. … There’s just a different buzz in the air.”

Even before playing a WNBA game, Clark has left her mark in the pros. The league’s draft had record viewership, and her No 22 Indiana Fever jerseys have been flying off the shelves. There were hundreds of fans walking around the arena in Clark jerseys and t-shirts.

CHICAGO — Kel’el Ware saw what Mike Woodson was able to do with Trayce Jackson-Davis.

That partially is what drew Ware from Oregon to Indiana.

Playing for a former NBA coach who’d just developed an NBA big convinced Ware that Woodson could put him on a similar path.

“He just told me he was going to get me back to where I needed to be,” Ware said. “If I chose to come to Indiana, he would be able to get me back here, he would be able to get me ready for it and I feel like that’s what he did.”

More: Indiana basketball’s Kel’el Ware declares for 2024 NBA Draft

As Ware noted at Tuesday’s NBA Draft Combine, Woodson was correct.

After a freshman season where he struggled at times for Oregon, Ware was allowed to play through mistakes at Indiana.

Ware entered the NBA Draft after one season with the Hoosiers in which he averaged He averaged 15.9 points, 9.9 rebounds, 1.9 blocks, 1.5 assists and shot 56.8%, including 42.5% from 3.

He will likely be a first-round pick next month.

“He was a top high school recruit. He was very athletic and could shoot,” said Connecticut guard Tristen Newton, who played against Ware when he was both at Oregon and Indiana. “That was his thing going into college and he displayed that (during Monday’s combine drills).”

That athleticism included one of the fastest 3/4 court runs as Ware, who measured 6-feet, 11 3/4 inches, blazed a trail in 3.29 seconds. Ware also had a 36-inch vertical.

Ware knows there are still concerns, though.

“The motor aspect of it, what everybody says about my motor,” Ware said. “I feel like I’ve proven that enough, but I still got more to prove.”

More: Indiana basketball’s Kel’el Ware isn’t sure he’s lock to go in first round of NBA draft

Otherwise, it’s easy to see why Ware is projected to go high in the draft.

He’s long (7-foot-4 1/2 wing span) and quick enough that he can guard on the perimeter. Ware can pick and pop, shoot and serve as a lob threat.

“My AAU coach he was telling me to bring the ball up the court sometimes,” Ware said. “I was never just a back to the basket player. I’ve always had the dribbling, shooting, I’ve always been able to do everything because I’ve always worked on it growing up.”

Sam King covers sports for the Journal & Courier. Email him at sking@jconline.com and follow him on Twitter and Instagram @samueltking.

U.S. Sen. Mike Braun — the Republican nominee for Indiana governor — made a surprise appearance at the National Healthcare Price Transparency Conference Monday, earning recognition for his work on health care price transparency on the federal level.

Conference emcee Gloria Sachdev, the president and CEO of Employers’ Forum of Indiana, presented both Braun and fellow U.S. Sen. Bernie Sanders of Vermont with an award recognizing them as “Champions of Healthcare Price Transparency.” The two, at opposite ends of the political spectrum, worked together on a measure to tackle transparency for hospital and insurer pricing. 

“This is reforming the system, not more government spending on it,” Braun said. “I’ll keep pushing hard for the five months or so that I’ve got left (in Congress). Hopefully we‘ll see that maybe cascade further. If not — and if I’m successful in November(‘s general election) — I’m going to be the most entrepreneurial governor the country’s ever seen on fixing health care.”

Braun’s appearance coincided with the release of the latest hospital prices study by the RAND Corp., a think tank, which found Indiana’s hospital prices were 8th-highest in the nation. Also on Monday, the Employers’ Forum of Indiana launched Sage Transparency 2.0, a dashboard providing cost breakdowns and revenue information for hospitals. 

The Indianapolis conference drew nearly 200 in-person attendees and dozens more online, with speakers like entrepreneur and venture capitalist Mark Cuban, national accountant experts, state legislators and patient advocates. The forum, which hosts the conference, seeks to improve health care transparency, prices and quality with an emphasis on the value for employers. 

Indiana’s hospital lobbying organization continued to push back against the RAND analysis, pointing to its own data on thin — or even negative — hospital margins and saying the study’s data provided a “distorted” view of prices in Indiana. 

“We’ve been rather consistent (with criticism) about the RAND reports in that they are presented, I think, without the proper context and usually with an agenda,” Indiana Hospital Association President Brian Tabor  told the Capital Chronicle. “When you look at the totality of what employers spend for medical services and health care services with our hospitals and health systems, you have to take into account that we have massive subsidies and financial losses associated with providing physicians.”

Tabor said the study didn’t include the entirety of spending on hospital and health system services, which would actually put Indiana in the middle of states in terms of costs nationwide. 

He also said Monday’s presentations “(beat) up on hospitals, particularly health systems,” without providing solutions or acknowledging the full context of Indiana’s low Medicaid reimbursement rates. 

Price data and information

The biggest takeaway from the RAND study was that employers paid, on average, two-and-a-half times more than Medicare prices — a federally set number that is supposed to be close to a “breakeven” number for providers giving care. 

But Chris Whaley, one of the RAND researchers and a professor at Brown University, noted that there is a lot of variation between states and within states but Indiana’s prices still ranked high even when compared with its neighbors. For example, Michigan’s prices compared to Medicare hovered below 200% while Indiana was closer to 300%, on average. 

“(We) collectively spend about $1.5 trillion on health care, with the largest chunk of the pie — half a trillion dollars — going towards hospitals,” Whaley said. “… hospital care, over the last few decades, has increased … by over 200%.”

Whaley said the purpose of the study was to give employers information on prices negotiated on their behalf. The analysis then compares prices at more than 4,000 hospitals and 4,000 ambulatory surgical centers with Medicare.

“Without both price transparency and market competition, it’s not possible to have an efficient market-based health care system. And so, if we’re going to keep relying on markets in the United States for health care, we need to have both greater transparency and improved market competition,” Whaley said. 

The key driver to prices appeared to be the percentage of market share a hospital system had in its area, not its quality or payer mix. That means hospitals with high low-income populations on government insurance programs fared no better or worse than their counterparts. 

The lack of market competition is a problem in nearly every corner of the country, according to Whaley’s analysis, and state legislators have been interested in exploring the impacts of monopolies on Indiana’s markets. 

Braun said that “sooner or later the (Federal Trade Commission) will get involved” when it comes to monopolies, stressing that he “(doesn’t) want the government meddling in anything other than keeping the markets competitive and fair.”

“… It’ll come apart,” Braun told attendees. “I’ve told CEOs of drug companies and hospitals, ‘You better start embracing (pushes for reform) or otherwise Bernie Sanders will run your business someday.”

Hospitals, however, say they’re struggling.

Indiana hospital prices named fourth-most transparent

A recent analysis from Kaufman Hall promoted by the hospital association found that Indiana’s hospitals had just a 1% operating margin in 2023, compared to national margins of 2.3%. Indiana hospital profits grew more sluggishly than their peers while expenses grew faster.

That directly contradicts what another Monday presentation from the National Academy for State Health Policy (NASHP) found. Its presentation, with a focus on its Hospital Cost Tool, found that Indiana’s hospitals had higher median net profits than the national average. 

Tabor said that presentation relied on information from Medicare cost reports, rather than audited financial data. But presenter Marilyn Bartlett with NASHP said the audited financial statements don’t provide the same breakdown for each hospital like Medicare cost reports do.

Kaufman’s analysis, on the other hand, uses audited financial data for the entire health care entity but not its investments — the same information bond markets use — according to Tabor.

“We’re increasingly seeing it’s difficult just to maintain access, even in our growing parts of the state. Hospitals have to pay for those services at what comes to large financial losses. So you have to combine the losses int hose physician practices, which are separate organizations — not on the cost reports … (to) look at the total financial picture,” Tabor said. 

The importance of transparency

Price transparency directly benefits patients and — by extension — employers, said Cynthia Fisher, who founded patientsrightsadvocate.org. Fisher detailed individual experiences of people trying to navigate the complexities of medical billing and ways her organization tried to support patients and intervene on their behalf. 

“Ninety-four percent of Americans want to know prices upfront. They want financial certainty and they do not want to be surprised by medical bills that they can never afford,” Fisher said. “Nor do employers want to be surprised.”

One woman received a quote for a hysterectomy at $5,000, only to see a $74,000 bill that her insurance denied to pay, Fisher said. The hospital eventually placed a lien on her house during payment negotiations. 

“She came to us with a financial … fear of losing her home,” Fisher said. 

Her organization’s intervention and review of the hospital’s pricing file found that the bill should have been closer to $8,000, but the process took more than four months.

“She proved it by having access to the actual prices. And what did she learn from that? Estimates don’t work,” Fisher said. 

While there has been national momentum to provide price transparency, Fisher said such standards are unevenly applied across the country. In states like Indiana, just over half of hospitals conform to such requirements compared to the one-third of hospitals nationwide posting prices publicly. 

“What we’re finding is that (U.S.) Health and Human Services and the federal government has been really slow to truly enforce this law and so we have seen only 14 hospitals been fined,” Fisher said. 

Tabor pushed back on this assessment, saying that the methodology was “subjective” and others had found nationwide compliance to be much higher — closer to 80%.

Price transparency efforts have spanned across three presidential administrations, most recently with President Joe Biden increasing fines to $2 million. Fisher said just two hospitals have been hit with those fines.

The lack of transparency has likewise influenced prices in drug markets, said Cuban, who co-founded Cost Plus Drug Company. The firm directly sells generic medications to consumers and has roughly 2,500 ones listed. It recently expanded to manufacture its own generic drugs.

Cuban compared his site, which shows a company markup of 15% alongside a $3 pharmacy handling fee and $5 shipping fee, with traditional pharmacy systems that often must negotiate prices with Pharmacy Benefit Managers or Third Party Administrators. 

He pushed the employers present to be proactive in accessing their claims data held by insurers or other contracting parties, something Indiana recently formalized in a 2024 law that requires such partners to allow access and regular audits. 

“The missing ingredient in health care isn’t the quality of health care, it’s trust. Other than your doctor, nobody trusts anyone,” Cuban said, urging employers to extensively negotiate their outside health care contracts. “… the future of health care in the United States is in your hands.”