News

Shortage of medical supplies for addressing COVID-19 is a challenge. Marianne Udow-Phillips explains.

In an interview with China Global Television Network anchor Elaine Reyes, Marianne Udow-Phillips, founding executive director of the Center for Health and Research Transformation at the University of Michigan, spoke to the challenges faced by hospitals and caregivers and the importance of managing the supply of medical equipment and drugs to treat COVID-19.

“Much of the focus is on mitigation because there is not really enough equipment here if we have a major spike in need,” said Udow-Phillips, as she discussed the emphasis on increasing the availability of testing and its importance in helping to anticipate potential surges in hospital utilization.

“The drug supply issue is another matter that is really of great concern here as well,” noted Udow-Phillips, who then went on to respond to questions about the availability of medical supplies and managing equipment challenges in rural hospitals.

Watch the interview here.

–Summary by Benjamin Kohrman

Udow-Phillips discusses Michigan proposal for Medicaid transformation office, value-based reimbursement

Marianne Udow-Phillips, CHRT’s founding executive director, shares her reaction to Michigan’s proposal to create a new Medicaid transformation office to move Medicaid toward a more value-based reimbursement system.

“The Michigan Medicaid program now performs pretty well on the cost side of the equation, but where are those areas for improvement?” asks Udow-Phillips. “We do not do well on infant mortality. It is good for the state to explore that . . . With long term care, (MDHHS) doesn’t have enough resources to track how well they are doing with home and community-based services supports. This would help people qualify for available programs to keep seniors out of nursing homes.”

The article by Jay Greene further explains that Michigan’s Department of Health and Human Services is focusing on modernizing the way that Medicaid uses tax dollars to improve quality, reduce costs, and address factors that cause patients to do poorly in the healthcare delivery system.

Read more of this Crain’s Detroit Business story.

Summary by Mary Herran

Udow-Phillips weighs in on gravity of drug shortages as coronavirus disrupts supply chain

With coronavirus striking the global east, Nathan Bomey of USA Today turned to CHRT for an article about U.S. reliance on the global pharmaceutical manufacturing supply chain. The article notes that overseas coronavirus-related logistics slowdowns pose a threat to domestic drug supplies, because of closed factories and policy changes in India and China.

Weighing in on the gravity of the situation, CHRT Executive Director Marianne Udow-Phillips says “supply chain disruptions could be truly serious for our access to drugs.” She also points out the importance of the issue to foreign manufacturers and suppliers. “I think it’s likely the Chinese government will do everything they can do to prevent that disruption because it’s so fundamental to their economy.”

The article provides some reassurance to readers, and clarifies the active efforts of hospitals, health systems, and the U.S. Food and Drug Administration to increase drug supplies and make alternative drugs available to patients.

Read the complete article here.

Michigan Health Endowment Fund releases national directory of recommended evaluation partners, including CHRT

chart, graph, data, health

“Evaluation can be a powerful tool to inform decision-making and ensure that scarce resources are used effectively,” writes the Michigan Health Endowment Fund in a recently released directory of evaluation partners that includes the Center for Health and Research Transformation (CHRT). The document lists 27 consulting firms–some in Michigan, others in California, Georgia, Illinois, Pennsylvania, Wisconsin, and Washington, DC–that the fund recommends to provide evaluation services to health-oriented organizations across Michigan. 

MHEF calls out CHRT for particular evaluative expertise in behavioral health, healthy aging, and community health impact. 

The Michigan Health Endowment Fund has been developing a robust evaluation capacity-building plan for grantees. The belief: that by improving the evaluative capacity of grantees, the fund can scale strategies and programs that improve the health of Michigan’s diverse residents; reinforce a cultural disposition towards curiosity, learning, and continuous improvement; inform decisions that enhance programs, strategies, and day-to-day operations; and build agility and responsiveness to adapt to changing conditions effectively. 

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Moniz in The Atlantic: The High Cost of Having a Baby in America

“This is the kind of money that causes people to go into debt.”

CHRT Health Policy Fellow Dr. Michelle Moniz

Research by Michelle Moniz, a 2018 CHRT Health Policy Fellow, is cited in “The High Cost of Having a Baby in America” by Olga Khazan for The Atlantic.

Vaginal deliveries, the researchers found, cost women an average of about $4,314 out of pocket in 2015, up from $2,910 in 2008. The out-of-pocket cost of a cesarean birth, meanwhile went up from $3,364 to $5,161 writes Khazan, citing newly published research by Moniz, Mark Fendrick, and others.

“I don’t have many patients who have that kind of cash just lying around,” says Michelle Moniz, an obstetrician-gynecologist at the University of Michigan’s Von Voigtlander Women’s Hospital and the lead author of the study. “I sometimes see patients struggling to afford their health care and sometimes choosing not to obtain health care because they can’t afford it.”

Read more at The Atlantic…

Hearing aids might reduce dementia risk says research by Elham Mahmoudi, a 2019 Health Policy Fellow

“The new study also suggests using hearing aids might help delay the onset of dementia in some people, and it’s the largest study to date to look at this possible connection.”

CHRT Health Policy Fellow Dr. Elham Mahmoudi

Research by Elham Mahmoudi, a 2019 CHRT Health Policy Fellow, is cited in “Research into the health effects of hearing loss suggests hearing aids might reduce dementia risk” by Consumer Reports.

“For people with hearing loss, using a hearing aid is associated with a reduced risk of three common health problems of aging — dementia, depression and falls — according to a recent study in the Journal of the American Geriatrics Society.

This study adds to the growing body of research that links hearing loss to memory issues and dementia. “Cognitive decline is much higher among people with hearing loss,” says study author Elham Mahmoudi, an assistant professor in the department of family medicine at the University of Michigan.”

Read more of this Consumer Reports story…

Rheingans in “Michigan finds some success fighting opiate crisis on front line: emergency rooms”

“The biggest challenge that ER docs have is that if somebody is ready for treatment, there’s not a place for them to go. Treatment can be different things for different people.”

Carrie Rheingans, acting human services director, CHRT

Carrie Rheingans, acting human services director, is quoted in this Bridge Michigan article by Ted Roelofs.

“A couple of months ago, Detroit resident Juanita Gross was desperate to turn her life around. She had a $200 a day opioid habit. She had already overdosed three times – and feared the next one might be her last,” writes Ted Roelofs in Bridge Michigan.

“So she had her two adult children drive her to the Detroit Medical Center Sinai-Grace Hospital emergency room, still in withdrawal from a mix of cocaine and the opioid oxycodone. Doctors there stabilized her and contacted Team Wellness Center Detroit, a mental health and substance abuse treatment agency….A day later, Gross was given an addiction medication that contained buprenorphine, considered by experts a potential life-saving treatment for opioid addiction when linked to comprehensive therapy….”

“Without this, I would be still using or dead or OD’d. It definitely saved my life,” Gross told Roelofs, who describes the effort as “part of a broader movement in Michigan and nationally to attack the opiate crisis on its frontline: the emergency room. The effort comes as opiate-related deaths reached a record high of 2,033 in Michigan in 2017, the last year of available data.”

Read more at Bridge Michigan…

Riba in “Michigan is facing a shortage of primary care doctors. Where does that leave patients?”

“… the length of time it takes people to get in to primary care. I think that’s a real issue.”

 

Melissa Riba

 

Carol Thompson of the Lansing State Journal notes that according to CHRT Research and Evaluation Director Melissa Riba, “over 80 percent of Michigan’s primary care physicians indicated they could take new patients” and 87 percent of patients “said they could get primary care fairly easily.” However, Thompson notes “physicians might say they can accept new patients, but that doesn’t mean they can accept them soon.”

Riba has heard similar anecdotes of patients who say they struggle to find a doctor to suit their health care needs, and “[W]hatever shortage patients feel now likely will get worse within the decade.,” writes Thompson. The article goos on to point out “In CHRT’s Michigan Physician Survey, about 45 percent of the physicians surveyed indicated they would retire and close their practices within 10 years.”

Read more at Lansing State Journal…

 

Subscribe to your doctor? A new model for medical care is catching doctors’ attention

“How do we better support primary care so we have viable numbers of primary care physicians for the future?”

 

Marianne Udow-Phillips

 

“Before insurance companies, and co-pays, and filing claims, the relationship between doctors and patients was simple,” notes Michigan Radio. “Those who needed medical care would visit their doctor’s office or request a house call. Once that care was provided, the doctor was paid directly. Some physicians are bringing that model into the 21st century by offering direct primary care to their patients on a subscription basis.”

On Michigan Radio’s Stateside with Cynthia Canty, “Marianne Udow-Phillips, director of the Center for Health and Research Transformation at the University of Michigan, notes that this model isn’t affordable for everyone, particularly because direct primary care doesn’t replace insurance….”

Hear more at Michigan Radio…

 

Budget fight looms over changes in Medicaid mental health in Michigan

“How we should deliver mental health services in Michigan is really a crucial issue. It’s a core question that is still on the table.”

 

Marianne Udow-Phillips

September 27th, 2019

“Mental health advocates are pressing Gov. Gretchen Whitmer to veto budget provisions they say could “irreparably damage” care for 300,000 low-income people in Michigan with serious mental illness or developmental disabilities,” writes Ted Roelofs for Bridge Michigan.

“While overshadowed by other budget showdowns, their warnings are the latest in a long-simmering skirmish over who should manage care for these individuals.

Under a plan first proposed by GOP Gov. Rick Snyder in 2016, Michigan was to privatize its $2.4 billion public mental health system by turning over state funding to Medicaid physical health plans as part of a plan to integrate physical and mental-health services for low-income patients.

Proponents said that merger would save millions of dollars while improving care. Critics said the switch would leave care for mentally ill and disabled in the wrong hands.”

Read more at Bridge Michigan…