FORT WAYNE, Ind. (WANE) -- How could Fort Wayne, the most affordable place to live in the U.S., have a hospital system with some of the highest prices? Answering that question is what led George Joseph, Investigative Reporter at The Guardian US, to write a 5,000+ word report published Thursday morning called ‘Unlimited dollars’: how an Indiana hospital chain took over a region and jacked up prices, part of a new "Too Big To Care" series. Joseph told WANE 15 he examined public data, obtained internal documents and spoke to a number of current and former Parkview employees at all levels to learn how Parkview Health has become the region's dominant healthcare system and largest employer. "Parkview, for many years, has used aggressive tactics, playing hardball with insurers, charging for items that staff say they shouldn't be charging for, and exerting their muscle through horizontal and vertical integration to charge some of the highest prices in the country," said Joseph. Parkview declined Joseph's repeated requests for an interview with CEO Rick Henvey and did not respond to Joseph's specific questions. WANE 15 asked Parkview for a response to the article and has yet to hear back. Joseph claimed to uncover a Parkview revenue strategy that rewards doctors, in large part, on patient volume and new patient encounters, quoting a former Parkview office manager as saying "The more you code, the higher you code, the more credit you get, which would translate to bonuses.” The Guardian U.S. article laid much of the blame for the aggressive pricing at the feet of former CEO Mike Packnett, who arrived in 2006 with current CEO Henvey alongside. "With the arrival of Packnett and Henvey, the hospitals’ operating revenues exploded, rising from around $700m at the close of 2006 to $1bn by the end of 2011 – a 40%-plus increase, though patient admissions only grew 11% during that period, according to Moody’s Ratings reports from the time." Packnett declined to comment about the Guardian story, but told WANE 15 before he retired he had not heard any criticism that the system was too big, saying Parkview's growth was a result of its care. "People know when they have an interaction with us..., we wrap our care around them and they become part of the family," he said in 2022. "We have grown significantly, but I think it's because people really get a sense that they're going to be taken care of well." Joseph said his investigation suggested Parkview used its market dominance in negotiations with insurance companies to craft better deals and leave other patients paying more. "The Guardian’s analysis also showed just how much costs could swing at Parkview depending on a patient’s coverage. ​​Parkview negotiates the cost of each procedure with each insurance company and on average, the difference between the maximum and minimum negotiated price varies by $30,000." Joseph, who investigated the mayor of New York City before his federal indictment and shed light on IBM's controversial video surveillance program for the Philippine government, welcomed additional people to step forward. "We hope that the people of Greater Fort Wayne care about this reporting and find it useful," he said. "To the extent that they have tips or further information that they want us to look into, we always appreciate readers coming to us with their story ideas."