CHRT begins new projects on legislative education, autism diagnosis, and mobility accessibility

A photo showing the room where Michigan's legislators meet in Lansing.

The Center for Health & Research Transformation (CHRT) is pleased to announce three new projects:

Health education for Michigan legislators and legislative staff

Due to the substantial turnover and subsequent loss of subject matter expertise in health issues in both the state House and Senate each election cycle, there is a need to support of both legislators and their staff. CHRT will provide one-pagers on policy-relevant health topics and their impact on the people of Michigan and will participate in legislative education fora to share and discuss with state leaders.

Early diagnosis of autism in Michigan

Earlier diagnosis of autism spectrum disorder (ASD) will allow patients to access services and resources sooner. CHRT will work with the Autism Alliance of Michigan on a plan to reduce disparities in diagnosis timing and enable earlier diagnosis in Michigan. 

Mobility accessibility in Washtenaw County

CHRT will work with Feonix Mobility Rising to create a Transportation Assistance Hub and Transportation Task Force in Washtenaw County, MI. This project aims to remove barriers to transportation access for community members.

A Q&A with CHRT Health Policy Fellowship alumnus Romesh Nalliah

Photo of Romesh Nalliah wearing a blue jacket, pink oxford, and pink and blue tie.

In 2018, Romesh Nalliah participated in CHRT’s Health Policy Fellowship. Now the associate dean for patient services and clinical professor of dentistry at the University of Michigan School of Dentistry, Romesh spoke with us about what he’s working on now–a number of equity initiatives–and how the fellowship training impacted his career.

Photo of Romesh Nalliah wearing a blue jacket, pink oxford, and pink and blue tie.

What are you working on now?

Leading up to 2020, my research was focused on the link between hospital outcomes and dental outcomes. But after the murder of George Floyd, I started to reflect on how all of the studies I saw showed that Black Americans have worse outcomes. I started thinking that I should study how race affects oral health. 

A couple of years ago I did a study looking at nationwide CDC data, and found that there has been a consistent gap between Black Americans and all other Americans in regards to oral health for the last 15 years. In fact, outcomes for Black Americans in 2014 are comparable to outcomes for white Americans in 1999. 

Another recent study we did found that, in the last 20 years, there has been no significant change in the proportion of Black students admitted to dental school. A few months after we published that study, a study came out showing similar results for medical schools.

Thanks to my time at CHRT in 2018, I also began to advocate for an improvement in adult dental Medicaid. After many meetings in Lansing by my group and many others, on January 1st of 2023 we saw a huge change in the reimbursement rate. 

Michigan had one of our nation’s worst adult dental reimbursement rates, and now it’s one of the best. There’s still advocacy work to do however, since our state has not attached any outcome measures to the increased rates, which means sustainability through budgetary cycles could be fragile unless we can change that.

What would you say makes this work important?

There are so many ways that oral health affects overall health, with dozens and dozens of studies supporting the association. Famously, there are associations between diabetes and oral health as well as between cardiovascular disease and oral health. However, not everyone knows that oral health is also associated with preterm birth and low birth weight. Additionally, we’ve done a study looking at stem cell transplants, and found a six day longer length of stay for patients who had concurrent periodontal disease. In fact, we found there was $85,000 in additional hospital charges, and a higher reinfection rate. We’ve done other studies with similar findings too. The mouth is part of the human body. So when there’s uncontrolled infection in the mouth, it affects outcomes in other surgical procedures.

How was your fellowship experience?

I participated in the fellowship in 2018, but for me the seeds were planted a decade earlier. Like many young researchers, I was excited to get published or do presentations. We were doing all these publications and presentations, and everyone was patting us on the back, and then one day I was presenting and two women stood up and said they wanted to thank our group because they used several of our papers to change legislation in their state. And I thought to myself, “Oh my goodness, they’ve done so much more than we’ve done with this data.”

Ten years later when I moved to Mighican and encountered CHRT, I thought it seemed like a great opportunity to learn. Because of CHRT, I now see the publication as the start of the process, and not the end. It’s just as important to get your findings in front of people that make a difference, like legislators and health policy advisors. That’s been a complete reframing for me.

I’ve interacted with legislators significantly more often since my time at CHRT, and because I’m in Michigan, I often ask CHRT for help. CHRT has also connected me with people who have changed the course of my research, including guiding me to more research on opioid over-prescribing in dental care.

The connection to the policy fellows was especially significant. Every time I go to Lansing, I try to meet up with as many of the policy fellows as possible – I continue to learn so much from them. They are sacrificing so much for their work, and they have such a passion and dedication. It’s very similar to researchers actually.

What are your plans for the future?

The fellowship has made me look at research in a different way. Now, I feel an urgency to publish a paper so we can move on to the real work, which is how does this affect the way that we practice dentistry?

Now, as the associate dean for patient services, my goal is to take some of what I’ve learned about quality and patient safety in hospital settings and apply them to everyday dentistry.

My dream is to reduce the operational separation between medical and dental. As an example, when my wife and I had our first baby I was shocked that, in all the prenatal appointments, there was not one conversation about oral health. Yet there’s 15 years of research about how oral health affects birth weight and preterm birth. One thing I’d love to see is a referral to a dentist as soon as someone begins their journey in starting a family. 

And it’s similar for cardiovascular disease, or diabetes. All these medical specialties should be requiring a trip to the dentist. It’s complex right now, because dentists are not co-located with hospitals and there are different insurance pathways, but that should not stop us from doing the right thing. I would like physicians to think about ensuring that conditions in the mouth are stable when they’re trying to address a systemic complaint.

Announcing the 2024 Health Policy Fellowship cohort  

Instructor speaking to a class of fellowship students

We are pleased to announce our 2024 Health Policy Fellowship cohort. 

More than 125 health researchers, policymakers, and nonprofit leaders have completed the fellowship since its launch in 2012. Many fellowship alumni occupy influential roles as policymakers and leaders across Michigan. 

The 2024 fellowship cohort will include:

  • Chelsea Alcock, Legislative Assistant, 52nd District, Michigan House of Representatives
  • Dr. Frank Conyers, Clinical Assistant Professor, Department of Neurology, Michigan Medicine 
  • Samantha Cornell, Director of Community Based Services, Access Health
  • Elizabeth Crenshaw, Director of District and Constituent Services, 7th District, Michigan Senate 
  • Jennifer Day, Community Building Manager, Michigan Breastfeeding Network
  • Thye Fischman, Manager of Government Relations,  Department of Government Relations, Michigan Medicine
  • Morgan Foreman, Director of Constituent Services, 33rd District, Michigan House of Representatives
  • Shannon Jackson, Program Manager, Residents in Action
  • Stephen Jackson, Policy Advisor, Michigan Senate Democrats
  • Dr. Patrick Johnson, Resident, Department of General Surgery, Michigan Medicine 
  • Dr. Beth Kuzma, Clinical Associate Professor, Department of Nursing, Michigan Medicine 
  • Kristina Leonardi, Director of Aging and Community Services Division, Michigan Department of Health and Human Services
  • Kelsey Ostergren, Director of Health Policy Initiatives, Michigan Health and Hospital Association
  • Beverly Ryskamp, Chief Operating Officer, Network 180

The program is an immersive four-month experience that brings together a diverse group of professionals to foster collaboration among policymakers, researchers, and nonprofit professionals. 

“The CHRT Fellowship enhanced my ability to think about policy—from the formulation of the research questions to the translation of the research findings to inform policy in real- time,” says Dr. Renuka Tipirneni, Assistant Professor of Internal Medicine, University of Michigan Medical School and Institute for Healthcare Policy & Innovation. “I valued going through the experience with an incredible cohort of both policymakers and researchers. This inter-sectoral peer mentorship enhanced my training and helped me build connections that I hope will last for my entire career.”

The 2024 cohort of Health Policy Fellows will engage in interactive workshops and learning sessions in Ann Arbor, Detroit, Lansing, and Washington, DC. These sessions are designed to provide fellows with opportunities to gain insights into local, state, and federal health policy landscapes. Orientation briefings will cover essential topics such as the legislative process, Michigan state government structure, strategies to effectively communicate with legislators, and the challenges in building sustainability for nonprofit organizations.

For further information about the CHRT Health Policy Fellowship and to apply for the 2025  cohort, please contact Holly Quivera Teague, Fellowship Program Manager, at


CHRT is grateful for the generous support of our 2024 fellowship sponsors: Blue Cross Blue Shield of Michigan, the Michigan Health Endowment Fund, Michigan Medicine, and the Michigan State Medical Society.

Providing decision makers with evidence: A Q&A with CHRT’s health policy team lead

Nancy Baum, systemic and policy analysis team lead
Nancy Baum, systemic and policy analysis team lead

CHRT’s health policy team evaluates laws, regulations and policies, as well as decisions and actions of leaders in public health, healthcare payers and providers, for their impact on population health. The team analyzes and recommends evidence-based policies designed to improve the health of people and communities, and responds to the needs and interests of a broad range of stakeholders. 

We sat down with Nancy Baum, the team director, to learn more about the team’s work.

Describe some of the challenges the health policy team addresses. 

One of our main goals is to help decision makers use evidence in their decisions. That’s a common theme of our particular team’s work, and it’s also most of what we do at CHRT. For our team, sometimes that means gathering information on what’s been published, what programs are in place, or what similar organizations or states are doing on a specific topic. Sometimes it means bringing people together to learn from each other, as we do in our two fellowship programs. We also have a project with partners at MSU to help educate Michigan legislators on health topics.

The decision makers we support could be legislators, but they don’t have to be. We’re also working with people who run programs, hospitals, or other health organizations. We want to get evidence into the hands of all decision makers who have an impact on health.

What’s one of the big projects in the team’s portfolio now?

One of the big pieces of work we’ve focused on for many years now is work we do with the Department of Health and Human Services for their long-term services and supports (LTSS) programming.

People with disabilities need supportive services that are very expensive. For the most part, Medicare doesn’t cover long-term services and supports. In most states, Medicaid does, but for the generally only people with a low income qualify for Medicaid coverage and services. So we have a system where there’s a great deal of demand, but the services are very expensive. And there are serious workforce problems meeting that demand because the pay for direct care workers is very low.

Michigan, like most states, has put together some important and effective programs for people who need these long-term services and supports. But many more people want them than qualify for them, and it is very important that these services are of high quality. So we work with the state to assess these problems, gather stakeholder input, and recommend some solutions.

Do you have any projects in the behavioral health space?

Our team works on a variety of projects related to behavioral health. For many years, we have had a shortage of behavioral health providers to meet demand in Washtenaw County. Without access to the care they need, people can develop acute behavioral health needs and present at the emergency department. Emergency departments are crowded and people with acute needs then have to wait a long time for appropriate services.

One of the really exciting projects we’re working on right now is called ADAPT (A Dynamic Approach to Psychiatric Treatment Systems). We’re working with modelers at the University of North Carolina who are building a model of Washtenaw County’s behavioral health system. This model will allow the community to understand what the impact on treatment experience might be if they change the level of resources committed to an aspect of the system. It’s exciting because this kind of work hasn’t been done before. We’re training this model on Washtenaw County data, but other communities will also be able to use it that have similar behavioral health systems and problems.

Do you work with other teams?

Absolutely. Our team is working closely with CHRT’s health and social equity team to find opportunities for community paramedics to deliver services to people in their homes, which helps keep people out of the hospital. For example, what often happens is that someone is discharged from the hospital but they have to do wound care at home. If they are not comfortable doing that then they might call emergency servicest, and historically paramedics had to transport them to the hospital. But someone who just needs a bandage change doesn’t necessarily need to be transported to the hospital, so delivering care to them in their home is more appropriate. These new programs allow community paramedics to deliver those and many other types of services in the home without transporting to a hospital.

Describe some of the processes the team uses.

Our team works to gather data. Sometimes we’re gathering primary data and analyzing it. Sometimes we’re exploring secondary data, aggregating existing evidence and knowledge, or conducting landscape analyses to see if there are best practices elsewhere that can be leveraged. We also do a lot of writing. We write reports, issue briefs, one-pagers and other materials to communicate what we learn.

We also run the two fellowship programs – a policy fellowship and a public health fellowship –  which let people meet colleagues, learn from one another and from experts in the field, and find opportunities to elevate the impact of their work.

Relationships are an important part of all of our work. The better relationships we have with decision makers, the better the opportunity we have to support them.

What do you want readers to know about the team’s mission, vision, values or services?  

We’re always thinking about how the policy or system we’re analyzing impacts various people and groups. When we’re talking about addressing social determinants of health, the big picture question is: does everybody have the resources they need and a real opportunity to improve their health? Or are there inequities where programs are helping certain populations the way they need help but not others?

Identifying places we can be more equitable is very important to everybody on our team, and really everybody here at CHRT. Providing decision makers with data on inequities can empower and enable leaders and organizations to take actions to help everyone improve their health.

A Q&A with CHRT’s new Executive Director, Joshua Traylor

Joshua Traylor
Joshua Traylor

Joshua Traylor joined CHRT as executive director on November 1. We sat down with him to learn more about him, his background, and his plans for CHRT.

What interested you in joining CHRT as ED?

I was born and raised in Washtenaw County so when the CHRT opportunity was posted, a few people from Michigan brought it to my attention. I had been working in the national policy space for quite a while and saw this as a great opportunity to come back to my home state and contribute to state and local reform efforts. 

At the federal level, you hope you’re doing good work, you hope your work is impactful, but you don’t necessarily see the work being carried out on the ground the way you do at the state or local level. For me, CHRT was offering an opportunity to re-engage with that state and local effort and make a tangible impact. I also saw joining CHRT as an opportunity to use what I learned at the federal level to help increase CHRT’s reach and impact. I know CHRT has done a lot of good work over the years, and there’s an opportunity to take what CHRT has done and use it to inform national healthcare policy.

Was that the first time you’d heard of CHRT?

I actually started my career at CHRT as an early career fellow right out of grad school. I worked primarily on the data analytics team and cut my teeth doing claims data work, writing issue briefs, and developing recommendations for clients. I also was active in the initial phases of the Washtenaw Health Initiative (WHI). 

What parts of CHRT’s mission and work are closest to your heart?

What I really like about CHRT is how interdisciplinary the organization is. I tend to think at a systems level about how different threads interact to create the outcomes we see. CHRT is one of the few organizations that brings together policy, data analytics, program operations, research, evaluation, and communications all under one umbrella. This is important because so many of the health and social issues we face are multisectorial. Addressing them requires many different components to move together and you need interdisciplinary teams to do that work. 

What attracted me about CHRT as an early career fellow was its healthcare policy focus. When I looked around Michigan, especially the Ann Arbor area, CHRT felt like the spot to be. I wanted that opportunity to dig into the data analytics work and understand how our healthcare payers, providers, and employers make decisions. I was looking for insight into how different stakeholders impact the way healthcare works on the ground, and CHRT was absolutely perfect for that.

What other knowledge and experience will you bring to CHRT? 

After my CHRT fellowship, I went to the Center for Medicare and Medicaid Innovation. CMMI was established to test innovative health care reform ideas intended to reduce costs and improve quality. I felt it was important to understand the impact of health care payment and care delivery reform efforts on behavior and outcomes. 

I started my time at CMMI working on the State Innovation Models (SIM) team where I got to see how different states and territories grappled with health care issues, and think about the ways federal policy could enable, or impede, that work. Next I went to the Prevention and Population Health Group, where I worked on the design of the Integrated Care for Kids Model where I learned a lot about the opportunities and issues with reform efforts in the Medicaid space. 

I left CMMI to join the Healthcare Transformation Task Force (HCTTF), a DC based non-profit that brings together healthcare payers, providers, purchasers, and patient organizations interested in payment and care delivery reform efforts. I had the opportunity to work with state and national payers, health systems, and patient advocacy groups to build consensus on a range of issues including payment model design, health equity promotion principles, and multi-payer alignment strategies. The Task Force was like a graduate program on topics you don’t learn about in grad school.

How did your work in DC intersect with what’s been happening here in Michigan?

At CMMI, I was the project officer for the State Innovation Model (SIM), so I was responsible for project management on the federal side of the program and interacted with a number of states, including Michigan. I provided technical assistance where I could and liaised with our grants office at the federal level to make sure we could fund things appropriately. I also looked for opportunities to connect the SIM folks in Michigan to other states, federal initiatives, and agencies that could inform their work.

What accomplishment are you most proud of?

I’ll give you three at different places. Early in my career at CHRT, I worked on the launch of the WHI, a voluntary collaborative of local individuals and organizations dedicated to improving the health of low-income, uninsured, and under-insured populations. I was interested in the concept that you could bring together so many different community level entities under one umbrella to improve care delivery. The WHI experience was really formative in my early career.

At CMMI, my work on the Integrated Care for Kids model. We began working on that model in 2015 and continued designing it through the 2016 presidential transition, when a lot was up in the air and a number of programs wound up not making it to fruition. I’m proud to have been a part of the team to design that model and shepherd it all the way through and make sure it got out the door as a funding opportunity for states.

At the Task Force, one of the biggest projects I worked on was called Raising the Bar, a Robert Wood Johnson Foundation (RWJF)-funded initiative to develop principles and action steps to advance health equity. It involved creating principles and action steps for healthcare organizations that were interested in advancing health equity. That effort has gotten quite a bit of traction and been used in a lot of different places.

What books are on your nightstand?

Right now? Goodnight Moon. I have a four year old and a two year old. Not a lot of free time for book reading beyond that!

But I would say a book that I have recommended time and again to students, mid-career, and even late stage career folks who want to understand the US healthcare system is a book called The Healing of America by T. R. Reid. 

We often talk about the U.S. healthcare system when what we really have is a collection of several health care systems. The Healing of America is one of the most approachable descriptions I’ve seen of all these healthcare systems and how they compare to those in other countries.

What do you do in your free time?

I love motorcycling, especially long distance motorcycle trips (though I don’t ride nearly as much since becoming a parent). I’ve ridden from Michigan to California and from DC to the Dakotas. I love to explore and I like to fix things so riding and motorcycle maintenance check both of those boxes. I also really like to garden and cook. If I have a garden and a well-stocked kitchen and folks to entertain, that’s my happy space.

What are your favorite places to visit in Ann Arbor or Michigan?

I grew up just outside Ann Arbor, and I went to school in Ann Arbor for my whole education from kindergarten to graduate school. The city changed a lot over that time but a few places feel like constants to me. I love the Arb, Kerrytown, and the farmers market. As a kid, I used to go to the Ann Arbor Y with my parents on the weekends and then after that we would go to the farmers market and Kerrytown for lunch. I have tons of fond memories of that area from childhood. And I’ve always loved walking through Nickels Arcade at Christmas time when all the lights are up and it’s snowing.

I also like North Campus. It’s an area not a lot of people go to unless you are in the engineering, music, architecture or urban planning programs. I was an engineering student for my freshman and sophomore years at Michigan. I appreciated the relative solitude of North Campus. There are also a ton of interesting hidden features you would miss if you didn’t know about them. For example, there is a natural echo chamber if you stand at one spot outside Pierpont Commons. There is also a grass field behind one of the engineering buildings that’s been shaped into a three-dimensional sine wave. It was designed and created by Maya Lin, the artist who did the Vietnam War Memorial in D.C. It’s a fun place if you have kids because they can run up and down the sine waves.

What are your goals for CHRT’s next few years?

Right now I’m in the phase of understanding all the work that’s going on and meeting all the leaders and partner organizations that CHRT is working with. The interdisciplinary nature of CHRT – bringing together policy, data analytics, research, evaluation, program implementation, communications, and finance – is a real strength for the organization. Our team also has experience working on a range of key health and social policy topics and initiatives. I think the perspective and skills of the CHRT team offers us the opportunity to help shape an ambitious but attainable vision for improving the health and wellbeing of our region and the state.

To be able to do this, I want to make sure we have good sustainable funding streams in place so we can support the ongoing work and be able to pursue the passion projects that attract people to work here.

Finally, I want to elevate the lessons learned at CHRT to the federal level and to create greater interconnection between CHRT and organizations that have similar missions in other parts of the country. I see a lot of opportunities for collaboration, shared learning, even partnership on projects.

What would you like to say to the CHRT community?

I’m really looking forward to getting to know the people who currently partner with CHRT, and to identifying new opportunities and new projects. CHRT has the opportunity to be a neutral convener and do the visioning work that pulls together different perspectives. I’m looking forward to partnering with people to do that.

Accepting applicants for the second annual Rebecca Copeland Memorial Internship

Rebecca Copeland
Rebecca Copeland

CHRT is now accepting applicants for the second annual Rebecca Copeland Memorial Internship.

CHRT seeks a high-achieving individual who is thoughtful and analytical, with interests and experiences in health policy analysis. This is a full-time paid summer internship, with flexible start and end dates. Graduate students who have completed at least one year of coursework in public policy or public health are encouraged to apply.

The intern will have the opportunity to work on relevant, timely health policy issues. The intern will be responsible for elements of health policy and research projects that align with CHRT’s mission of improving the health of people and communities.

Apply now or learn more.

About the CHRT Rebecca Copeland Memorial Internship

Rebecca Copeland was a dual masters degree student in public health and public policy at the University of Michigan, and graduated in the spring of 2021. She had a deep interest improving population health by addressing social needs. Rebecca sought out mentorship from Terrisca Des Jardins, CHRT’s former executive director serving from late 2020 – February 2023. 

Rebecca was deeply committed to improving health, health care and social justice. She brought enthusiasm and excellence to analysis of important health policy issues and inspired those alongside whom she worked.

At CHRT, Rebecca interned with Nancy Baum, CHRT’s health policy director. At CHRT, she worked to improve the public mental health system, among other projects. “Her energy was amazing,” says Baum. “Rebecca showed us just how valuable interns can be in an organization like ours. When an intern is both smart and dedicated to making systems better to improve health, as Rebecca was, they are a real asset,” says Baum.

Rebecca Copeland passed away in July 2021. CHRT and the RAC Fund for Social Justice honor her memory by offering the Rebecca Copeland Internship to graduate students at the Gerald R. Ford School of Public Policy.

Welcome new staff and interns

4 new staff and inters

CHRT is pleased to introduce its newest hires in finance, data use, and programming. New finance team members will enhance our organization’s ability to conduct financial planning, ensure compliance, and improve operational procedures. New programmatic staff members bring expertise in health information technology, data use, public policy, mental health and substance use disorders, and more. 

Gudrun Bossman

Gudrun Bossmann is a senior financial analyst at CHRT and is responsible for financial planning. She holds a bachelor’s degree, with honors, in international business and management studies from the Hanzehogeschool, Groningen, The Netherlands.

Prior to joining CHRT, Bossmann built up the financial controlling of a media research company in Ann Arbor and managed financial operations for the premium resort sector of Thomas Cook, one of the largest travel companies in Europe.

Ayşe G. Büyüktür

Ayşe G. Büyüktür is a senior research area specialist with the University of Michigan School of Information and holds appointments at the Center for Health and Research Transformation (CHRT) and the Michigan Institute for Clinical & Health Research (MICHR).

Büyüktür first started working with CHRT in 2016 as a consultant for the Livingston – Washtenaw State Innovation Model (SIM) intervention, the predecessor to MI Community Care. She subsequently joined the intervention team in the design, implementation, and operations of the program.

Allison Fritsch 

Allison Fritsch is an intern at CHRT. She is a Master of Public Health and Master of Social Work dual-degree candidate (2022) at the University of Michigan.

Before coming to the University of Michigan in 2020, Fritsch worked in the hospitality industry.

Wendy Hawkins

Wendy Hawkins is a senior health policy analyst at CHRT. She graduated with her master’s in public policy from the University of Michigan Gerald R. Ford School of Public Policy in 2021.

Prior to joining CHRT, Hawkins worked in the harm reduction field in San Francisco and Los Angeles, providing harm reduction materials and support to people who use drugs and those experiencing housing instability. She also provided HIV/STI and Hepatitis C testing and referrals to wraparound services.

Amy Martinez

Amy Martinez is University of Michigan School of Public Health, Future Public Health Leaders Program (FPHLP) fellow, completing her field placement with CHRT. She is currently pursuing her bachelor’s degree in psychology and public health at Williams College, located in Williamstown, MA

Prior to joining CHRT, Martinez served as a public health intern in the Berkshire Area Health Education Center (AHEC) where she helped develop mental health and COVID-related programming for improving healthcare professionals’ relationships with themselves and their patients during and post-pandemic.

Augustina Nguyen

Augustina Nguyen is a University of Michigan School of Public Health’s Future Public Health Leaders Program (FPHLP) fellow. She graduated from Wheaton College in Massachusetts in 2021 with a BA in biology and business management.

Before joining CHRT, Nguyen was a public health intern at the Brigham and Women’s Hospital, doing health equity research and intervention.

Angela Palek

Angela Palek is a senior financial specialist at CHRT. She holds a master’s degree from Michigan State University in higher, adult, and lifelong education and a bachelor’s degree from Central Michigan University in administration, with an emphasis on organizational administration.

She began her career at Eastern Michigan University working for the EMU Wraparound Project which provided wrap around services for at-risk teen parents. While at EMU, she was instrumental in the development of the non-profit student food pantry.

Ivana Tullett

Ivana Tullett is compliance staff specialist at CHRT, with a focus on regulatory data compliance and data privacy. She holds a master’s degree in law from the Charles University in Prague and a master’s degree and research doctorate in law from the University of Michigan Law School.

Prior to joining CHRT, Tullet supported the University of Michigan research enterprise by negotiating data use agreements and coordinating related compliance reviews.

Luoluo Xu

Luoluo Xu is a senior accountant at CHRT, supporting the administrative and business functions. She holds a master’s degree in accounting from Eastern Michigan University.

Prior to joining CHRT, Xu worked as an accountant for MHealthy, which offers U-M faculty and staff a broad range of health and well-being programs, and the U-M Shared Services Center, which oversees a range of human resources and financial administrative functions across the University. 

New CHRT projects focus on integration, learning networks, and social determinants of health

A binder that reads New Projects

CHRT has launched six new projects over the past few months, including designing a public health and primary care integration demonstration project, participating in a learning action network team to support integrated delivery networks, launching a new practicum and fellowship for Detroit Health Department staff members, and providing training in communicating for policy change to a national network of cancer care organizations.


Coaching members of a national learning and action network of integrated care delivery leaders

National: Institute for Healthcare Improvement (IHI)

While understanding that the social conditions in which a person lives, works, and plays is critical to health, only 24 percent of hospitals and 16 percent of physician offices report screening patients for social needs. More and more, however, health systems are recognizing the imperative of understanding the social needs of their patients and helping to resolve unmet social needs that directly impact health, well-being, and equity. 

In order to support the journey of these health care organizations, Pfizer is funding work with the national Institute for Healthcare Improvement (IHI) to create a Learning and Action Network. CHRT’s executive director will participate in a multi-disciplinary national faculty team that provides coaching and guidance to competitively selected integrated delivery networks. Read more

Integrating public health and primary care and developing sustainable funding mechanisms for both systems

National: American Board of Internal Medicine (ABIM) Foundation

The lack of connection between primary care and public health has had serious consequences during the COVID-19 pandemic. Public health messages about the measures necessary to keep people safe–masking, social distancing, the need for internal eating closures, and the like–have been highly politicized. But in many communities, it was hard for public health leaders to reach and convince their constituents.

CHRT is working with the American Board of Internal Medicine (ABIM) Foundation to Identify ways to integrate public health and primary care and to develop sustainable funding mechanisms to strengthen both systems. In the first phase of this work, CHRT will focus on key informant interviews with representatives from a range of organizations and entities such as public health and primary care professionals from states with advanced integrated systems and states identified by the National Health Security Index 2020. Read more

Expanding the Home Nutrition+ integrated infrastructure

Regional: Michigan Health Endowment Fund

Several national studies have demonstrated a return on investment for nutrition programs. Specifically, a Commonwealth Fund review identified multiple papers that provide strong evidence that medically tailored meals (MTM) improve outcomes and have a positive return on investment. Furthermore, the Commonwealth Fund found that a community-based care transition program, provided to older adults as part of a combined MTM intervention, saved $3.87 for every $1.00 spent, likely driven by a significant decrease in the 30-day readmission rate in the intervention group.

Vital Seniors Initiative grantees–five social service agencies for which CHRT provides backbone support–are forming a community integrated network with the goal of delivering MTM and coordinated service delivery to clients. The end goal: To more effectively and efficiently serve older adults and individuals with disabilities so they can remain in their community and home of choice. To do this, the network needs to develop a hub model structure, governance, and operations as well as new partnerships to expand the Home Nutrition+ program.

CHRT will provide backbone support to the community integrated network, helping network members develop strategic objectives with existing partners, develop the governance structure required to support expansion, set up the appropriate legal agreements, engage with community-based organizations beyond Washtenaw County, and develop the framework to offer Home Nutrition+ based on the “Food is Medicine” model.

During the first quarter, CHRT will identify potential geographic regions for expansion, conduct an analysis of services and gaps of MTM offerings in those regions, engage with a health plan to support the operational objectives for expansion, and conduct visioning sessions to define mission and execute delivery. During the second quarter of the grant period, CHRT will facilitate governance and geographic expansion decision making, set up legal structure and applicable agreements, and more. Read more

Public Health

Developing and delivering a fellowship and practicum for Detroit Health Department staff

Local: Detroit Health Department

In 2019, CHRT launched the Detroit Health Department Public Health Practice and Policy Engagement Fellowship, training two cohorts of DHD staff in four key areas–systems thinking, communications, policy engagement, and data analytics–so they may ultimately lead collaborative, cross-systems work, eliminating silos and addressing the social determinants of health. A shortened, supplemental virtual fellowship for alumni will continue to elevate their public health skills and professional development experience.

CHRT will lead alumni in a six-session fellowship, covering a host of current policy issues and trends. The alumni fellowship will touch on long-standing, complex issues of public health, many of which have been exacerbated by COVID-19. It will create a space to identify and discuss these dynamic problems and provide tangible ways for fellows to address them and affect change. The fellowship also includes a small-group practicum project, focused on real issues faced within DHD departments. At completion, the fellows will have a fleshed-out plan for improving processes–one that is rooted in systems thinking. Read more

Healthy Aging

Informing the development of Michigan’s statewide LTSS strategic plan

State: Michigan Department of Health and Human Services

In 2019, the Michigan Department of Health and Human Services (MDHHS) engaged in preliminary preparation for strategic planning activities around long-term services and supports (LTSS). MDHHS has now asked CHRT to facilitate a comprehensive process to inform a statewide LTSS strategic plan.

In Phase I, CHRT will review MDHHS work to date and interview key staff. CHRT will then conduct an environmental scan of federal policy and funding changes, both planned and existing, as well as examples of how states are applying these federal changes. CHRT will review best practices on equity initiatives and key LTSS options, then develop a white paper on LTSS options. CHRT will also conduct a series of internal and external key informant interviews, and complete a literature review on home- and community-based services, with high-level recommendations for the state. Read more

Communication for Policy Change

Training members of a national cancer care consortium in communicating for policy change

National: Alliance to Advance Patient-Centered Cancer Care 

The national Alliance to Advance Patient-Centered Cancer Care seeks to ensure that findings from the alliance’s six participating sites and cross-site evaluation–particularly those that demonstrate evidence-based mechanisms for advancing patient-centered care and reducing disparities–reach, inform, and inspire national decision and policy leaders.

CHRT is collaborating with the alliance around communicating for policy change. The focus: Developmental editing, as alliance staff write a policy brief to share with national policy and decision leaders, and webinar development and delivery to help alliance members in several states as they communicate their own findings to policymakers and practitioners. Read more

Special open enrollment period allows Michigan consumers to purchase 2021 health insurance on national ACA marketplace

Health Insurance paperwork with a pen

On January 28th, President Biden signed an executive order to initiate a nationwide special enrollment period and reopen the ACA Health Insurance Marketplace. The Marketplace will reopen from February 15 – May 15, which will give consumers in Michigan (and in 35 other states that use the federal exchange) an additional opportunity to purchase 2021 health insurance coverage amidst the backdrop of the COVID-19 pandemic.

The state of Michigan experienced a 46 percent increase in the number of uninsured adults from February to May of 2020, due in large part to the pandemic.[1],[2] While over 267,000 Michiganders were able to enroll in health insurance plans during the regular 2021 open enrollment period, a 2 percent increase from the 2020 open enrollment period, thousands of Michiganders currently remain uninsured.

Governor Whitmer has announced that the state of Michigan, in tandem with this special enrollment period, will be launching outreach efforts to help uninsured Michiganders learn more about the coverage options available to them. Many uninsured individuals may find that they have subsidies that are large enough to cover the entire cost of a health insurance plan.

For more general information regarding the 2021 Health Insurance Marketplace, including an in-depth rate analysis, see CHRT’s Rate Analysis: 2021 ACA Health Insurance Marketplace for Michigan. To explore health insurance plans available through the Marketplace, visit

[1] State Leaders Applaud Biden Administration for Opening Marketplace Special Enrollment Period and Making Medicaid more accessible. (2021, January 28). Retrieved February 11, 2021, from,4669,7-192-29943_34759-550797–,00.html

[2] A 46% increase equates to roughly 834,000 Michiganders without health insurance coverage.

Webinar: CHRT Policy Analytics Director Robyn Rontal offers webinar on policy solutions to support family caregivers

Paperwork marked Policy

In this hour-long webinar by Policy Analytics Director Robyn Rontal, viewers will learn about the current state of informal and family caregiving in the U.S., factors that impact caregiver stress, and a variety of policy solutions to support family caregivers.

Rontal discusses the prevalence of family caregiving and the impact of the COVID-19 pandemic on caregivers and families. She presents research showing that almost 40 percent of caregivers find their caregiving situation to be emotionally stressful, and shares examples of strategies to address these problems with policies at the local, state, and national level.

Listen to Policy solutions to support family caregivers to learn more about ways we can support unpaid caregivers in the U.S.