In The Media Archives

Health navigators say Medicaid members benefit from plain language, reduced administrative burden

On June 30, State of Reform published an article relating the results of a newly released CHRT study about the effectiveness of Michigan Department of Health and Human Services (MDHHS) outreach methods to Medicaid members. The study explored MDHHS communications around the implementation of Medicaid work requirements for the Healthy Michigan Plan (HMP) in early 2020.

While Medicaid communications are traditionally text heavy and technical, MDHHS used simplified language, streamlined the format, and employed attention-grabbing colors and icons in letters to beneficiaries. MDHHS also used administrative data to automatically exempt individuals who were not required to report work hours.

Patrick Kelly, who completed the study while working as a senior analyst at CHRT, explained that “the department took a number of steps to make their communications more easily digestible or human-centered to draw more attention to their communications to Medicaid beneficiaries.”

In a series of focus groups and a survey, health care insurance navigators reported their belief that these new communication interventions worked better than previous methods.

Lessons learned from this study could be effectively applied to other public benefit programs and policies to improve implementation and ensure that everyone can receive the benefits they are entitled to.

Cited publication: Kelly RP, Marcu G, Hardin A, Iovan S, Tipirneni R. Health Navigator Perspectives on Implementation of Healthy Michigan Plan Work Requirements. JAMA Health Forum. 2022;3(6):e221502. doi:10.1001/jamahealthforum.2022.1502

MLive cites CHRT’s study on the impact of long COVID on Michiganders

Microscope picture of a COVID virus. In this article, MLive summarizes research findings about long COVID, and cites CHRT’s study on the disease impact on Michiganders and Michigan’s economy.

“We want to raise an alarm, raise a flag to say ‘hey, this is potentially going to be and could be a really big deal for policymakers, for the state, for the economy, for the health care system and we need to be prepared,” said Melissa Riba, CHRT research and evaluation director.

The CHRT survey found that common ongoing symptoms include breathing issues, loss or distorted sense of smell or taste, and mental health issues, as well as nervous system symptoms, neurologic problems, diabetes, heart problems, kidney damage, and fatigue.

“I like to think this is sort of the tip of the iceberg with long COVID, because everything about this virus and this pandemic and this disease is so new and every day we’re still learning more stuff,” said Riba.

CHRT’S STUDY MAIN FINDINGS ARE:

One in three Michiganders with COVID-19 are “long haulers” or someone experiencing long COVID.
15% of men and 55% of women identified as long haulers.
Michiganders with diabetes were two times more likely to report long COVID.

READ MLIVE ARTICLE

READ CHRT’S BRIEF

CHRT research cited in Michigan Radio story about the effects of long COVID on women

Michigan Radio cites CHRT’s study on the impact of long COVID on Michiganders in “Women may be experiencing more long COVID than men. We don’t know why.” The article by Kate Wells focuses on why women are more vulnerable to long COVID, and other diseases that disproportionately affect women, and how Michigan-based health systems are supporting individuals with long COVID.

“We could possibly approach a million, and even higher than a million, long COVID cases in Michigan,” says Jonathan Tsao, lead author of CHRT’s brief in the story, going on to explain that “long haulers are more likely to be in a worse financial situation than a year ago compared to those who recovered from COVID and those who never got COVID.”

“[With] all these long term chronic conditions, it is very debilitating for individuals to function at their full working capacity,” says Tsao. “Those who’ve experienced these symptoms, they were more likely to either work reduced hours, or decide to voluntarily quit, or even get laid off from their jobs due to the demands of their jobs as well.”

Tsao is hoping employers are paying attention, and make accommodations just “like any other disability that might happen in the workplace.” But women will likely be most impacted — not just because they experience more long COVID, but because they already were more likely to work in sectors that saw COVID-related job cuts, or have to take on caregiving responsibilities during the pandemic.“What we want them to take away from this … is basically that they’re not alone,” Tsao said. “There’s a lot of people who are going through what they’re going through.”

CHRT’s STUDY MAIN FINDINGS ARE:

One in three Michiganders with COVID-19 are “long haulers” or someone experiencing long COVID.
15% of men and 55% of women identified as long haulers.
Michiganders with diabetes were two times more likely to report long COVID.

READ MICHIGAN RADIO ARTICLE

READ CHRT’S BRIEF

CHRT cited in State of Reform: long COVID’s effect on physical, mental, and financial health of Michiganders

State of Reform features CHRT’s research on the impact of long COVID in Michigan.

According to the CDC, long COVID—also known as post-COVID—is when “people who have been infected with the virus that causes COVID-19 experience long-term effects from their infection.” CHRT classified long COVID in people “who have had COVID symptoms continue for weeks or even months after initial infection,” said Jonathan Tsao, Research and Evaluation Project Manager at CHRT and one of the authors of the study.

“Long COVID is still all so new and it’s all new territory. We’re still learning and understanding what the effects of the virus are on physical health, mental health well-being, and financial and economic well-being,” said Melissa Riba, Research and Evaluation Director of CHRT. “We are seeing the intersection of long COVID, income disparities, and gender disparities.”

According to the report, Michiganders who identify as long haulers also suffer from financial hardships. Reports show that some long haulers are more likely to take medical leave, reduce their work hours, have their salaries reduced, or quit their jobs. This is because they are unable to function as they did before COVID.

The main findings are:

1 in 3 Michiganders with COVID-19 are “long haulers” or someone experiencing long COVID. Tsao said if you apply this data to Michigan COVID statistics now—not including COVID deaths—there have been a little over 2 million total cases, which would leave about 700,000 people who might have long COVID in the state.
15% of men and 55% of women identified as long haulers. The study also found that women are nearly 4 times as likely to report long COVID. Tsao said this matches the national research on women affected with long COVID.
Michiganders with diabetes were 2 times more likely to report long COVID. In the study, individuals with diabetes are at a higher risk because the disease impairs the immune system and damages organs.

“Depending on how many future cases of COVID exist, it likely could creep to a million or even exceed a million in the long term,” said Tsao.

READ THE STATE OF REFORM ARTICLE

READ CHRT’S BRIEF

Bridge Michigan quotes Samantha Iovan on paramedics and insurance coverage.

Bridge Michigan quoted Samantha Iovan, health policy senior project manager at CHRT, in their recent article, “Home-visit programs save money, free ERs. Many insurers don’t cover them.”

Paramedics do much more than taking patients to the ER. However, most medical insurances only cover trips to the ER. According to Iovan, that payment model fails to recognize 911 calls that can be safely treated in a patient’s home. While this makes up a small portion of 911 calls, that portion is still significant. Spending time in a patient’s home also allows community paramedics to identify other forms of social assistance that would help patients with health issues, and ultimately prevent more trips to the ER.

“If the community paramedic is going into a house for someone unable to manage a chronic condition, maybe that’s because they don’t have transportation. If they are food insecure, they can connect them to a food pantry. The paramedic can serve as this connection to community organizations that can help.”—Samantha Iovan, Health policy senior project manager, CHRT

READ THE ARTICLE

Nancy Baum’s Q&A with “State of Reform”

Nancy Baum is the health policy director at CHRT. In this Q&A, she discusses CHRT’s latest research projects, behavioral health legislation, and the future of Medicaid enrollment in Michigan.

Baum starts her interview by explaining how the end of the public health emergency might result in a very high disenrollment rate in Medicaid.

“At the end of the public health emergency, states have 12 months where they can figure out exactly who is no longer going to qualify for Medicaid. During that time, there are opportunities for communities to come together to try to keep as many people enrolled as possible.”

She also further discusses Michigan’s behavioral health system and changes that are being proposed in the legislature. Social determinants of health and care services coordination are at the forefront of her current work at CHRT.

Baum also talked about projects that are related to addressing social determinants of health (SDOH).

“So we’ve had incentives in Michigan for physician organizations and health systems to begin to collect some data from patients about what their social needs are. We’re just starting to really put some shape around how we share that SDOH data and how we coordinate care between people in community-based organizations.””

Baum was asked by SOR about what she thinks of the specialty integrated plan legislation being discussed.

“There’s decades of evidence that show integrating physical and behavioral health care services for individuals really matters.”

READ THE Q&A

Affordable Care Act sign-ups surge in Michigan, uninsured rate hovers just above 5%

More Michiganders signed up for 2022 health insurance during the federal government’s recent open enrollment period for the Healthcare.gov marketplace than any year since 2017, and the estimated number of uninsured people in the state continues to hover just above 5%.

That was up nearly 14% from last year’s open enrollment numbers, which followed a shorter enrollment period that ended Dec. 15 in 2020, according to a federal report.

Policy experts attribute this surge to temporarily more generous premium and deductible subsidies that came with the $1.9 trillion American Rescue Plan relief package that President Joe Biden signed last March. This subsidy expansion will expire at the end of the year.

The Detroit Free Press reported on the change, and quoted Samantha Iovan, senior health policy project manager at CHRT.

“That was definitely the biggest change and why we saw such high enrollment this year,” said Iovan. “Previously, you consistently would see people who were getting plans that were 20% of their household income. So that was a big change that made more people eligible for subsidies.”

About 50% of people nationwide are eligible for the Silver Plan, which Iovan noted many people consider to be the best coverage for the most affordable cost.

READ THE ARTICLE

Reflecting on the Washtenaw Health Initiative’s 10 year anniversary

A new article in On the Ground Ypsilanti reflects on ten years of Washtenaw Health Initiative (WHI) accomplishments.

The Washtenaw Health Initiative is a voluntary collaboration to improve the health of low-income, uninsured, under-insured, and underrepresented people in Washtenaw County.

Co-sponsored by Michigan Medicine and the St. Joseph Mercy Health System and supported by the Center for Health and Research Transformation (CHRT), the Washtenaw Health Initiative helps 200+ members and stakeholders work together to:

Improve coordination across providers and integrate health and human services locally;
Support community-wide efforts to improve care and services for mental health, substance use, and other health issues impacting vulnerable populations;
Strengthen community-wide efforts to improve health equity by working closely with the Washtenaw County Health Department;
Increase insurance coverage among uninsured individuals and help those with Medicaid and Marketplace health plans maintain their coverage, use it more effectively, and find access to care;
Help local and regional health agencies reduce service redundancies and use resources more efficiently and effectively;
Connect community resources to health care organizations and to each other; and
Explore opportunities to partner with Livingston County health and human service organizations.

“When information is shared like that in a community, that community can only become better for it,” said Sharon Moore, WHI co-chair.

The article, written by Jaishree Drepaul-Bruder, discusses the WHI’s work to address the opioid epidemic, insure 100% of the population, and support healthy aging.

READ THE ARTICLE

Nancy Baum on Medicaid funding for Certified Behavioral Health Clinics (CCBHC)

State of Reform quoted Nancy Baum, health policy director for the Center for Health and Research Transformation (CHRT), in an article by Patrick Jones on funding for Certified Community Behavioral Health Clinics (CCBHCs).

Published on October 19, 2021, the article reports on a press conference announcing that thirteen Michigan CCBHCs will be fully funded by Medicaid in the same way that community health centers are funded for physical care. The Michigan Department of Health and Human Services (MDHHS) will also allocate $26.5 million state and federal dollars to support all CCBHCs. The initiative will allow for a sustainable flow of funding to these CCBHCs, which will allow CCBHCs to plan for future expansions, reduce jail time for those in crisis, and create job security for providers. CCBHCs are integrated health centers that provide mental health, substance use treatment, and physical health to all, regardless of the ability to pay.

Baum shared many advantages of this more sustainable revenue source. CCBHCs will no longer have to chase grants, they may have an easier time hiring health professionals because of improved job security, and they will be able to plan for the future.

“When you have sustained funding, you can say ‘we are investing in you’ [to employees] and we [can] have predictable services for our community. Sustained funding allows for planning, and it allows for organizations to think about how [they] can do what [they] do even better, instead of spending all their energy just looking for sustainable funding.”

Baum believes the funding will allow CCBHCs to plan to expand services and create lasting, efficient teams.

READ THE ARTICLE

Melissa Riba quoted in Bridge Michigan on reinstituted copays and deductibles for COVID-19 patient cost-sharing

Hospital billing statement for covid Bridge Michigan’s Robin Erb and Makayla Coffee quote Melissa Riba, director of research and evaluation at the Center for Health and Research Transformation (CHRT), in “Costs rising for Michigan COVID care with return of deductibles, copays.”

The story discusses an upcoming shift in patient cost burden for COVID-related illnesses—costs that have largely been waived by Michigan’s largest insurers for more than a year, ensuring that patient costs remained low.

By September 30, 2021, at least six insurers will resume charging copays and deductibles for COVID-related care.

Riba explains that while we’ve tried to encourage more Michigan residents to get vaccinated through a variety of incentives, this shift represents “the leading edge of the stick” in a carrot-and-stick approach.

She notes that shifting the COVID-19 cost burden to patients signals “moving away from the incentives to more of the penalties associated with making a choice to be non-vaccinated,” a shift that reflects a national trend among health plans as vaccines have become widely available to the public.

Dr. Michael Genord, CEO of Health Alliance Plan, agreed with her. “There’s been a lot of effort for people to take personal responsibility for the prevention of COVID that we didn’t have before.”

Insurers have noted that waivers for cost-sharing were intended to be temporary before vaccines were available.

READ THE ARTICLE

News

CHRT’S STUDY MAIN FINDINGS ARE:

CHRT’s STUDY MAIN FINDINGS ARE:

The main findings are: