Marianne Udow-Phillips on why Michigan hospitals are laying off workers even as they battle coronavirus

As part of their continuing Health Watch series, Bridge Magazine continues their focus on hospital staffing and the economics behind the perplexing circumstance of health care workers losing their jobs during a health crisis. Writing for today’s Bridge, Brie Zeltner notes that the surge in coronavirus patients has increased staffing and equipment costs even as COVID-19 treatments bring in less revenue than the outpatient and elective procedures that have previously been the foundation of hospital business models.

Marianne Udow-Phillips, CHRT’s founding executive director, points out that the need to reserve space for coronavirus patients also affects hospital occupancy rates — further compounding challenges to the hospital bottom line. “We have a lot of [COVID-19] patients,” Udow-Phillips said, “but it’s a relatively small percentage of our total capacity.”

The article points out that the widening gap between costs and revenue is also a concern for many rural hospitals in Michigan — and thousands across the U.S. — many of which were facing financial challenges and potential closure before the coronavirus struck. Udow-Phillips reflected on what health care systems will need to recover, and raised the possibility that mergers and consolidations may accelerate as hospitals and providers seek to bolster their fiscal positions.

“Health care systems are going to need more support, because the system is going to have to retool and regear,” she said.

Read the entire Bridge article here…..

–Summary by Benjamin Kohrman

In Powering Up, we explore the disproportionate impact of COVID-19 in African American communities

powering up

Marianne Udow-Phillips, founding executive director of the Center for Health and Research Transformation, joined Anne Doyle for this week’s Powering Up! podcast, “African Americans Bearing the Brunt of U.S. COVID-19 Pandemic.”

Detroit, Michigan, one of the COVID-19 hot spots in the U.S., is bearing witness to the disproportionate impact the pandemic is having on African American communities. To date, 35 percent of the virus victims in Michigan are African Americans, although they make up only 15 percent of the state’s population. The same is true in other U.S. states with significant African American populations.

Podcast guests Marianne Udow-Phillips, former director of the Michigan Department of Human Services, and Vernice Davis Antony, former public health officer for Detroit, both saw this coming, writes Powering Up, because they each have decades of expertise in the devastating toll of generational poverty and the weaknesses in the U.S. health care system.

Listen to “African Americans Bearing the Brunt of U.S. COVID-19 Pandemic.” 

In Detroit, CHRT’s Cover Michigan Survey illuminates health care access challenges for HuffPo, Type Investigations

detroit, buildings

In “Detroit’s health care workers ask: ‘How many lives can we save?’ a Huffington Post and Type Investigations story, Patricia Anstett, Jonathan Cohn, Tom Perkins, and Anna Clark describe the impact of coronavirus in “one of the most segregated regions in the country, where a separate-and-unequal system magnifies racial disparities.”

“As of Wednesday, COVID-19 had infected more than 7,141 Detroiters and killed 469 of them,” write the authors. “Michigan, which has reported 1,921 coronavirus deaths, has the country’s highest death rate. Of the statewide death count, 80 percent have been in the Detroit region. Wayne County, where Detroit sits, has more deaths than the state of California.”

A lack of access to health care has exacerbated the situation in Detroit, where “more than 30 percent of the city’s residents had trouble paying medical bills in the last 12 months,” write the authors. They are citing Cover Michigan Survey findings, not yet published, from the Center for Health and Research Transformation.

Read more of this powerful investigative story online.

Marianne Udow-Phillips offers insights on complex hospital staffing issues during the COVID-19 crisis

michigan, disease

As hospitals and health systems across Michigan scramble to address a surge in COVID-19 patients, there is competition over the short supply of highly sought-after critical care nurses – driving up labor costs and pulling some Michigan nurses away from their regular jobs to take higher-paying temporary positions. In “Michigan nurses getting fat pay raises or pink slips in coronavirus crisis,” Bridge Magazine takes an in-depth look at this trend and related hospital staffing issues that have a direct impact on the ability of hospitals and caregivers to manage the coronavirus caseload across Michigan.

The article notes that in some cases, Michigan critical care nurses are being lured out of state by lucrative offers from hospitals in other regions, and some Michigan hospitals are seeking staffing help from other states and health systems that are not currently as over-burdened by the coronavirus crisis.  Even as some hospitals are in a bidding war to hire critical care nurses for coronavirus care, Bridge Magazine’s Kelly House notes that other health care workers are losing their jobs as elective procedures, planned surgeries, and outpatient medical services are being cancelled during the pandemic.

“As the coronavirus pandemic leaves a trail of devastation in Michigan, it is also defying the laws of health care workforce supply and demand, creating a maddening musical chairs of labor, forcing executives to adjust in real-time, and fueling frustrations among some workers who say they’re tired of being called heroes but treated like pawns,” House writes.

The perplexing circumstance of health care workers losing their jobs during a health crisis has led to calls for retraining so that those workers can assist on the front lines. “But retraining workers in the midst of a pandemic could prove tricky, said Marianne Udow-Phillips, founding executive director of the Center for Health and Research Transformation at the University of Michigan and a former director of the Michigan Department of Human Services. “You’ve got everybody deployed to the front lines and you don’t have the capacity to do that kind of training,” Udow-Phillips said. “But it’s a lesson learned for what we could do to prepare for the future.” Udow-Phillips also notes that policy changes at the state and federal level could help Michigan and other states be better prepared for future pandemics.

Read the full Bridge Magazine article here.

–Summary by Benjamin Kohrman.

PPE supply shortages aren’t helped by halting abortions writes Dr. Jen Villavicencio

ppe, disease

“On any given day, I deliver babies, screen for cancer, provide urgent consultation in emergency rooms, perform complex surgeries and provide abortion care,” writes Jen Villavicencio, a Michigan Medicine OB-GYN and CHRT Health Policy Fellow, in a Bridge Magazine op-ed that responds to calls to shut down abortion clinics to preserve personal protection equipment.

“As a board-certified OB-GYN, I know the necessary resources involved in the practice of medicine. And as someone providing essential health care during the COVID-19 pandemic, someone who has volunteered to be “deployed” outside of my specialty to coronavirus wards and field hospitals, I am deeply committed to excellent stewardship of resources.

Political groups working to ban abortion argue that health centers providing abortions should be “shut down” to preserve critical personal protective equipment (PPE). As a doctor actively caring for patients during this pandemic, I understand how desperately important access to appropriate PPE is — I need it to protect my life and the lives of my family.  I also know that stopping abortion care in Michigan will do absolutely nothing to improve the PPE shortage….”

Read more in Villavicencio’s Bridge Magazine Op-Ed….


Public Health Work has Never Been More Important


“In the world of public health, so many of our days are spent working behind the scenes — preventing disease, protecting health and the environment, preparing for disasters — that we often say the best outcome is one that is invisible,” writes Lisa Peacock, a CHRT Health Policy Fellow and a Health Officer for the Health Department of Northwest Michigan. “But who could have imagined this? We’ve seen a pandemic before, we’ve seen natural disasters, we’ve seen terrorist attacks, but in our lifetime we have not seen a virus literally stop the world in its tracks like coronavirus.”

“Our public health work has never been more important. Hospitals are worried about their inpatient and critical care capacity, employers are worried about their employees, local government is managing critical functions, and the public wants to know what they can do to protect themselves and their loved ones. Now, instead of behind the scenes activity, public health is front-and-center, the subject of almost every conversation across Northern Michigan, and everyone asks, “What can we do?” Without a cure and without a vaccine, the most important things we can do are to practice the age-old public health principle of social distancing and abide by the governor’s order to stay home whenever possible…..”

Read more of Peacock’s op-ed in the Petoskey News Review Opinion page….

Udow-Phillips offers perspective as China Global Television examines U.S. health system amid coronavirus

Lending context to China Global Television Network’s scrutiny of the U.S health system’s response to the coronavirus crisis, CHRT Executive Director Marianne Udow-Phillips explains that lack of health coverage is “…a huge concern in the middle of coronavirus, because this is a pandemic, it doesn’t hit just people who are insured.”

The story looks at U.S. health system policy issues around the Affordable Care Act and considers how some policies can lead to varying pandemic responses at different levels of government. “There is no central entity in the U.S. which makes policy decisions for the whole health care system,” says Udow-Phillips. “Sometimes we have decisions made at the federal level which might conflict with decisions made at the state or local level.”

CGTN goes on to question whether the federal response to the pandemic occurred early enough and was adequate, and Udow-Phillips provides some historical context for the U.S. government’s approach. “One of the reasons we’re seeing this huge spike in cases is we were not prepared,” Udow-Phillips said. “Underfunding of public health is a longstanding problem.”

Watch the interview with Roee Ruttenberg here.

For independent, rural hospitals, coronavirus may pose an existential threat. Udow-Phillips explains.

In “Rural Michigan hospitals say coronavirus may soon force some to close,” Marianne Udow-Phillips, executive director of the Center for Health and Research Transformation at the University of Michigan, describes the thin cash margins of independent, rural hospitals and why they’re so vulnerable during this coronavirus epidemic.

To slow the spread of the virus, elective surgeries and procedures have been cancelled, which has a huge impact on hospital bottom lines.

“All hospitals are challenged,” says Udow-Phillips, a national health policy expert and a lecturer at the University of Michigan’s School of Public Health and Ford School of Public Policy.

“But rural hospitals have huge cash issues. They have very thin if any cash margin, so they don’t have what they need to weather the ups and downs.”

Udow-Phillips says she’s “worried about whether many of our rural hospitals will be able to weather this for any period of time.”

Read more in Ted Roelofs’ Bridge Magazine story.

Udow-Phillips praises state leaders on the actions they’re taking to combat the spread of coronavirus

Marianne Udow-Phillips

As coronavirus continues to spread across the globe, U.S. leaders in our nation’s capital have struggled to roll out a national plan of action writes ABC News reporter Ivan Pereira in “State governors taking lead on coronavirus precautions as federal government works to define plan.”

Marianne Udow-Phillips, founding executive director of CHRT, tells ABC News that state leaders have stepped up to fill the breach with cancellations, shutdowns, and other needed interventions.

“Governors hear directly from health care providers, the local business community, school leaders and citizens at large,” says Udow-Phillips. “They are deeply attuned to local and statewide impacts.”

This familiar relationship between the governors and their communities places them in a crucial position to take the actions necessary to alleviate pressing issues.

Read more of ABC New’s story.

Summary by Bill Minsung Kim

Bartholomew discusses the healthcare system changes proposed by Democratic presidential candidates

Ryan Bartholomew, a health policy analyst at CHRT, offers insight on the different approaches to improving our healthcare system proposed by Presidential hopefuls Joe Biden and Bernie Sanders in “How Democratic Presidential candidates want to change health care.”

“The largest benefit is if you are a fan of the private health insurance marketplace,” says Bartholomew of Biden’s proposal. “If you like the plan that you have, the public option doesn’t impact you in any way, […] It would be just an option that other people would be able to purchase and you would still be able to keep your current plan if that’s something that you like.”

The article by Malachi Barrett delves into the differences between to two proposed healthcare systems with Biden pushing to build on former the Affordable Care Act, while Sanders pushes for Medicare for All.

Read more of this MLive story.

Summary by Bill Minsung Kim