In The Media Archives

Marianne Udow-Phillips discusses the impact and future of the ACA during 10th anniversary panel

During a virtual panel in October 2020 moderated by John Z. Ayanian, the director of the University of Michigan’s Institute for Healthcare Policy and Innovation (IHPI), and Dr. Howard Markel, the director of the University of Michigan’s Center for the History of Medicine, Marianne Udow-Phillips discussed the impact and future of the ACA.

The panel, which also included John McDonough of the Harvard T. H. Chan School of Public Health, Jonathan Cohn who covers the ACA for the Huffington Post, and Gail Wilensky, a health economist and senior fellow at Project Hope, an international health foundation that supports health workers worldwide, was scheduled to mark the occasion of the 10th anniversary of the ACA.

The panelists first addressed what changes they would suggest for the ACA. Udow-Phillips highlighted shortcomings of the ACA including the high out-of-pocket costs for health care for many individuals, especially those at or above 400 percent of the federal poverty level. Her suggestion was to increase government funding for health care in order to lower the cost of care. Additionally, Udow-Phillips stressed the importance and value of Medicaid as well as similarities between the individual marketplace and the Medicaid marketplace such as rates, silver-loading, and techniques of managing care.

Udow-Phillips said she was most surprised by the “degree of politicization to the Public Health and Prevention Fund” of the ACA. She emphasized the need to increase funding for public health, which is currently only 3 percent of the nation’s healthcare expenditures. This issue was only exacerbated by COVID-19, and Udow-Phillips said public health funding “needs to be fixed” moving forward.

The ACA, which was enacted by Congress and signed into law by President Barack Obama, was brought to the Supreme Court for the 3rd time on November 10, 2020. A key piece of the ACA, the individual mandate, was previously upheld by the Supreme Court, however, the Trump administration lowered the individual mandate to an amount of $0. This change gives the Supreme Court grounds to reanalyze the constitutionality of the ACA. Udow-Phillips says she would not expect the “Supreme Court to rule the whole ACA is unconstitutional.”

The panel also considers the future of health care in America; Udow-Phillips expects that our nation will slowly move away from employer-based health insurance over time. Other topics discussed included pre-existing conditions, the relationship between health insurance and small businesses, and the ACA’s impact on children.

WATCH THE PANEL DISCUSSION

CHRT on WJR’s Guy Gordon Show: Findings from a study of Michigan’s COVID-19 nursing home policy

During the September 9 Guy Gordon Show on WJR Radio, CHRT Founding Executive Director Marianne Udow-Phillips shared findings from the new CHRT report, Keeping nursing home residents safe and advancing health in light of COVID-19.

In his introduction, Gordon recognizes CHRT’s emphasis on evidence-based findings in the report. “There’s a new study by the Center for Health and Research Transformation that took a very analytical approach to data,” Gordon noted.

Gordon was also interested in legislative concern about the state’s early policy of sending some recovered COVID-19 patients back to nursing homes, and whether that practice had then contributed to the spread of COVID-19 among non-hospitalized nursing home residents. “We don’t have any evidence right now in the data we’ve looked at that there in fact was spread within nursing homes themselves,” said Udow-Phillips.

Udow-Phillips went on to point out that the CHRT report did find room for improvement. “We think the whole system can be made better, certainly in Michigan and nationally as well, and we’ve made 50 recommendations going forward for things that we think can be improved.”

The research emphasizes the necessity for continuing support and monitoring, in order to give nursing facilities the tools they need to effectively manage the pandemic. It also suggests that while creating regulations and processes for monitoring visitors, staffing, and PPE in nursing homes, the state should take into account the experiences of other states.

LISTEN TO THE ENTIRE WJR RADIO CONVERSATION HERE

Michigan Advance features CHRT interim report on Michigan’s COVID-19 nursing home hub strategy

Image of magnifying glass and a graph report

In Michigan’s handling of COVID-19 in nursing homes fares better than national average, Michigan Advance writer Allison Donahue covers a recent CHRT study which found that the state is reporting fewer COVID-19-related deaths in nursing homes than the national average and that the state’s “hub” strategy has been effective.

The CHRT report — Keeping nursing home residents safe and advancing health in light of COVID-19 — was written after extensive data analysis, a comprehensive exploration of peer-reviewed literature, and numerous interviews with national policy experts, state administrators, and nursing home leaders, along with hospital and clinical leaders.

Donahue notes that “Michigan’s handling of the COVID-19 crisis in nursing homes has been under scrutiny from the GOP-led Legislature. The U.S. Department of Justice (DOJ) requested that Gov. Gretchen Whitmer submit data related to nursing homes and COVID-19 deaths last month along with other Democratic governors.”

The article goes on to point out that at the press conference detailing CHRT’s summary report, Michigan Department of Health and Human Services Director Robert Gordon said “If you look at the evidence together, it says the opposite of the criticisms.”

According to CHRT’s analysis, the percentage of deaths among nursing home residents with COVID-19 was considerably lower in Michigan’s nursing home hubs than in the state’s non-hub nursing homes — 17.4% in hubs compared to 26% in non-hubs.

READ THE ENTIRE MICHIGAN ADVANCE ARTICLE HERE

In Crain’s Detroit: CHRT’s examination of Michigan’s nursing home hub strategy in response to the COVID-19 crisis

In a September 8 article Report: Smaller percentage of nursing home residents died of COVID-19 in Michigan than national average, Crain’s healthcare writer Jay Greene talks with CHRT Founding Executive Director Marianne Udow-Phillips about CHRT’s examination of the state of Michigan’s nursing home hub strategy in response to the COVID-19 crisis.

“We collectively believe that the state’s strategy was appropriate when taken during the peak of the surge to establish nursing home hubs and transfer patients from hospitals (when patients) were no longer in need of hospital-level care,” Udow-Phillips tells Crains.

Greene also notes that the CHRT report — funded by the Michigan Health Endowment Fund – was the product of data analysis and numerous interviews with national policy experts, state administrators, and nursing home leaders, along with hospital and clinical leaders to identify best practices.

The article goes on to point out that the CHRT report also focuses on improvements going forward.

“Overall, CHRT issued 50 recommendations for improvement, covering structural, process, access, and operational improvements, to help Michigan and other states prepare long-term care facilities, including nursing homes, for a potential resurgence.”

The report emphasizes the significance of communication and cooperation between nursing facilities, state agencies, and public health officials as well as the necessity of proper staffing, testing, and personal protective equipment. The report also emphasizes the need to prioritize the mental health and social needs of nursing home residents during the pandemic.

READ THE REPORT

CHRT on Michigan Radio: More changes needed for Michigan’s COVID-19 response in nursing homes

In a New report suggests more changes needed for Michigan’s COVID-19 response in nursing homes, Michigan Radio journalist Will Callan talks with CHRT Founding Executive Director Marianne Udow-Phillips about a CHRT report published in September, 2020 that examines “how Michigan’s health department could better manage COVID-19 in nursing homes.”

The report, Keeping nursing home residents safe and advancing health in light of COVID-19, compares Michigan’s COVID-19 response to similar efforts in other states, and makes a number of recommendations, including providing additional support for nursing home staff with more training resources and extra pay.

Callan’s discussion with Udow-Phillips also focuses on the report’s finding that nursing homes that had strong relationships with local hospitals did a better job of controlling infections. “But not all nursing homes have that,” said Udow-Phillips. “So we are recommending strengthening and formalizing those relationships.”

READ THE ARTICLE

Use local doctors to promote mask use says Marianne Udow-Phillips in WLNS interview with Tim Skubick

Image of health professionals wearing masks

Gov. Gretchen Whitmer is being advised by the former director of the state welfare department to use someone else to promote the mask use, instead of choosing sports icons.

Tim Skubick of WLNS interviewed Marianne Udow-Phillips, founding executive director of the Center for Health and Research Transformation (CHRT), for a segment about the recently released mask pitch by Michigan-based sports coaches.

“It was quite a coup for the [Michigan] governor to sign up well-known sports personalities like Michigan State University basketball coaches Tom Izzo and Suzy Merchant to encourage the use of masks,” said Skubick. “If it was up to Marianne Udow-Phillips, the former state welfare director during the Granholm administration, she would advise the governor to use local doctors.”

Skubick is referring to a recent study done by CHRT and the University of Michigan Department of Learning Health Sciences, which discovered that the people Michiganders trust most for COVID-19 information are their local doctors.

“I think that would be a great idea,” says Dr. Marianne Udow-Phillips. “I think if people heard from their own personal physicians, people they know and trust, that they have confidence in, that these health care persons would save lives and it would have a huge impact.”

READ THE ARTICLE

About half of Michiganders trust Whitmer, Faucic; 27 percent trust Trump reports Michigan Radio

Vector art of a politician Kate Wells, reporting for Michigan Radio, interviews Marianne Udow-Phillips for a segment on where Michiganders get COVID-19 information and which sources they trust most and least.

“I think the experience we’re seeing in the field, where people aren’t always wearing masks or where you see gatherings–is reflected in this data,” says Udow-Phillips, founding executive director of the Center for Health and Research Transformation. “I do believe a lot of it has to do with the conflicting information people are getting.”

Healthcare providers have been deemed the most trustworthy sources of COVID-19 information, says Wells, reporting on the survey results. Udow-Phillips says that’s an opportunity for public health officials to use providers as messengers.

“They could mobilize our health care providers to be giving more direct messages to their patients,” says Udow-Phillips. “I think that there’s a good reason why health care providers are more trusted. It’s because they have a personal relationship with their patients. And yet they’re not doing the outreach in terms of helping patients follow public health guidance. And so I think this survey really speaks to engaging our frontline health care providers, primary care physicians in particular, to be giving the public health messages.”

LISTEN TO THE SEGMENT

Coronavirus contact tracing faces increasing challenges as some Michigan residents are reluctant to participate

“Almost a third of Michigan residents would not be comfortable participating in contact tracing linked to cases of coronavirus, according to a new survey released this week by the University of Michigan,” writes Julie Mack for MLive. Mack is referring to a new report that shares findings from the latest Cover Michigan Survey by CHRT and the University of Michigan Department of Learning Health Sciences.

“Two-thirds being willing to engage is good, but not enough because contact tracing is very important to our ability to really mitigate the spread of the disease,” says Marianne Udow-Phillips, founding executive director of CHRT, who provided the background for the story.

“About 33% of survey respondents said they were not comfortable with using a phone or computer app to share symptoms with a local or state health department official; 27% said they were uncomfortable with sharing additional personal information to limit the spread of coronavirus, and 23% said they were uncomfortable with providing officials with names of “close contacts” who the patient may have infected,” reports Mack.

Mack notes the many challenges Michigan’s local public health departments have been facing with contact tracing, in spite of the fact that the Michigan Department of Health and Human Services now has 422 trained volunteers making calls for 16 of the state’s 45 local public health departments. “At this time we are attempting to contact 90% of all contacts within 24 hours and are reaching 60%,” says Lynn Sutfin, a spokesperson for the Michigan Department of Health and Human Services.

Mack spoke with several local public health officers, as well, including those who are using the state contact tracing volunteers and those who are doing their own contact tracing. “Just having tracers isn’t enough,” said Mark Cheatham, health officer for the Mid-Michigan District Health Department. “Because of COVID denial, we increasingly run into people who won’t talk to us, won’t tell us who they have had contact with. So because of the hostility, we’re getting bogged down.”

Case investigations also are getting more complicated, said Lisa Peacock, a 2020 CHRT Health Policy Fellow and public health officer for the the Benzie-Leelanau District Health Department and the Health Department of Northwest Michigan. Peacock told MLive that her department “recently had 14 cases that involved 80 close contacts between them — all people that need to be notified of their potential exposure.”

READ THE ARTICLE

Cover Michigan Survey featured in MLive: Whitmer, Fauci among Michigan’s most-trusted sources on coronavirus

“Dr. Anthony Fauci and Michigan Gov. Gretchen Whitmer are the biggest sources of coronavirus information for Michigan residents and also among the most-trusted sources, according to a new survey released today by University of Michigan,” writes Julie Mack for MLive.

Mack is referring to a new brief, published by CHRT and the Department of Learning Health Sciences at the University of Michigan, that shares result from a representative survey of more than 1,000 Michiganders. The survey asked about where Michiganders acquire information about COVID-19, and how much they trust those sources of information.

Eighty percent of respondents stated that their healthcare professionals are the most-trusted sources, yet they do not receive information from them, according to Marianne Udow-Phillips, director of CHRT.

Marianne Udow-Phillips, who provided the background for the story, says several things are at work in Governor Whitmer’s high trust rating.

“[The governor] is very visible, and also very empathetic and her messages have been consistent. She has repeatedly emphasized that she is guided by science,” says Udow-Phillips. “I think what we’re seeing are governors in our country who are aligning with public health professionals are more trusted. People trust science. They do trust the professionals.”

READ THE FULL STORY HERE

CHRT and DHLS in Crain’s: The public trusts health care providers, but they aren’t getting enough information from them

“People trust health care providers, public health officials, and Governor (Gretchen) Whitmer more than many other sources when it comes to communicating important messages about COVID-19,” says Melissa Riba, CHRT’s director of research and evaluation, in a new Crain’s Detroit Business article by senior health care journalist Jay Greene. “But an overwhelming majority (74 percent) of respondents to the survey also said they are worried that Michiganders are less safe because of misinformation being spread about COVID-19,” reports Greene, sharing findings from CHRT’s most recent Cover Michigan Survey.

Some 80 percent of survey respondents reported that the COVID-19 information source they trust in their own healthcare provider, but less than half of the respondents reported receiving COVID-19 information from their healthcare provider.

“The public trusts health care providers, but they aren’t getting enough information from them,” Marianne Udow-Phillips told Crain’s. “That is an opportunity for health care providers to become a leading source of trusted information.”

The problem reports Greene, is that doctors and other healthcare providers don’t often provide direct information to their patients, a practice that Udow-Phillips says should change. Doctors could speak authoritatively of the benefits of wearing masks in public, a practice that all experts now agree can contribute to reducing community spread, Udow-Phillips told Crain’s. “My own health care provider hasn’t contacted me, saying, ‘You should be wearing a mask,'” she said. ‘It could help if they heard from their own doctor.”

Researchers concluded that to combat COVID-19 it is critical for the public to trust the information they receive. “But the disconnect between high trust and simultaneous low use of information sources will challenge public policymakers and health practitioners, requiring diligence in selecting the messengers, channels, and platforms that resonate best with Michigan residents as the state moves into the next phase of pandemic response,” researchers said.

READ THE FULL CRAIN’S DETROIT BUSINESS STORY HERE

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