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CHRT study shows Michigan’s mental health system broken, lacks capacity, care not integrated

The Center for Healthcare Research & Transformation (CHRT) today released data showing that while one in four Michiganders reported being diagnosed with depression and/or anxiety, finding mental health services is difficult for consumers in most areas of the state, a fact confirmed by primary care providers seeking to refer patients.

The research brief, “Access to Mental Health Care in Michigan,” examines the need for mental health care along with capacity of Michigan’s health care system to serve people with mental health needs. Findings show that the increase in mental health coverage under the Affordable Care Act will be limited in its ability to help those most in need unless the state also expands capacity.

Read moreCHRT study shows Michigan’s mental health system broken, lacks capacity, care not integrated

Reports show the way Americans receive and pay for health insurance has been changing for more than 10 years

The Center for Healthcare Research & Transformation (CHRT) today released two briefs showing that for more than a decade, employers have been dropping health insurance and consumers have been paying more out-of-pocket for health care, a trend that began many years before the development of the Affordable Care Act. The research briefs also show Michigan’s employers are increasing employee cost-sharing and moving to high deductible health plans at a faster rate than the national average.

According to the data, from 1999 to 2011, the proportion of individuals covered by employer-sponsored insurance decreased by approximately 15 percent nationwide. Between 2008 and 2011 specifically, the proportion of people with private health insurance (either through their employers or individually-purchased) fell 4.7 percent in Michigan and 4.4 percent nationwide.

Read moreReports show the way Americans receive and pay for health insurance has been changing for more than 10 years

Recession, increase in uncompensated care severely strain Michigan’s health care safety net, says Center for Healthcare Research & Transformation

A report released today by the Center for Healthcare Research & Transformation (CHRT) outlines the severe impact of Michigan’s recession on the ability of the health care safety net to provide health care to the growing number of Michigan residents who need their services.

From 2007 to 2011, uncompensated care provided by Michigan hospitals increased 42 percent, and patient volume at federally qualified health centers (FQHCs) increased by 22 percent. The number of uninsured increased by 133,000, yet there was no net increase in the number of free clinics statewide. In fact, five of seven free clinics in the Upper Peninsula closed, leaving just two clinics for the entire population.

“These trends emphasize how important the Medicaid expansion in Michigan is in terms of access to care,” says Marianne Udow-Phillips, director of CHRT. “The demand for low and no cost care through federally qualified health centers has increased in Michigan. At the same time, some free clinics in the state have closed anticipating that Medicaid will expand. If the expansion does not occur, there will be further pressure on the FQHCs in the state to provide access or more care will likely be delivered at the nearest emergency room, further escalating the rate of uncompensated care that hospitals provide.”

The strain on the health care safety net results in cost shifting to private insurers, higher premiums, and a continuation of the cost/access challenges evident in Michigan and nationwide, says Udow-Phillips.

CHRT’s review of Michigan’s health care safety net includes additional findings, such as:

  • The Medicaid coverage rate increased steadily from 12.2 percent of the population in 2007, to 17.5 percent in 2011.
  • The number of patient visits for medical, dental, substance use and mental health care at FQHCs increased from 1.6 million in 2007 to nearly 2 million in 2011.
  • At FQHCs, mental health visits increased by 128 percent, far surpassing the increased visits for dental care (36 percent), medical care (21 percent) and substance use services (11 percent).
  • While the total number of free clinics remained at 75 across the state, the geographic distribution changed greatly. Southeast and Southwest Michigan saw increases in the number of free clinics, yet the Upper Peninsula lost seven of nine clinics.

The report also points to the gradual reduction of disproportionate share hospital (DSH) payments as a challenge for hospitals. These federal funds help compensate hospitals that care for a higher proportion of uninsured patients. Beginning in fiscal year 2014, these payments will be reduced and will eventually cease.

This publication is the fourth in the Cover Michigan 2013 series. Future publications will cover other aspects of health care in Michigan.

CHRT Projects Regional Impact of ACA, Medicaid Expansion Across Michigan

The Center for Healthcare Research & Transformation (CHRT), based at the University of Michigan, today issued projections on the likely coverage effects of the Affordable Care Act (ACA) in Michigan– both with and without an expansion of the Medicaid program. The projections focus on the adult population, aged 19-64, that will be eligible for Medicaid if the state approves its expansion and adults that will be eligible for tax credits to subsidize private coverage via the health insurance exchange.

“While there will be many people in Michigan who will be able to choose health plans through the new insurance exchanges starting this fall, most will continue to get their coverage through their employers or through Medicare or Medicaid,” says Marianne Udow-Phillips, director of CHRT. “If the state does expand Medicaid, we estimate that approximately 127,000 people will enroll in health plans through the new insurance exchange and, 320,000 additional people in Michigan will become covered by Medicaid.”

Read moreCHRT Projects Regional Impact of ACA, Medicaid Expansion Across Michigan

Medicaid recipients are the most satisfied with insurance coverage; individually insured least satisfied, says Center for Healthcare Research & Transformation

A report released today by the Center for Healthcare Research & Transformation (CHRT) shows that Medicaid recipients in Michigan were the most satisfied with their health care coverage in 2012, while those with individual coverage were the least satisfied. This finding gives some insight into to how consumers may react when new qualified health insurance products under the Affordable Care Act go into effect in 2014.

The survey, conducted in partnership with the Institute for Public Policy and Social Research at Michigan State University, asked 1,018 Michigan adults to rate their satisfaction and experience with their health insurance, based on whether they had Medicaid, Medicare, employer-sponsored or individually- purchased coverage.

Read moreMedicaid recipients are the most satisfied with insurance coverage; individually insured least satisfied, says Center for Healthcare Research & Transformation

Less than 10 percent of Michigan’s small businesses impacted by Affordable Care Act’s health coverage mandate

The Center for Healthcare Research & Transformation (CHRT) today released a brief showing that more than 90 percent of Michigan’s small businesses are exempt from the health insurance mandates that become effective January 1, 2014. The brief also outlines the decision areas that all small employers should consider when determining how to participate in health coverage under the Affordable Care Act.

CHRT’s brief, The Affordable Care Act and Its Effects on Small Employers, shows that 96 percent of Michigan’s 154,488 private-sector small businesses have fewer than 50 employees, exempting them from penalties if they opt to not offer health coverage. The Affordable Care Act (ACA) requires employers with 50 or more full-time-equivalent employees to offer health coverage or pay a penalty.

Read moreLess than 10 percent of Michigan’s small businesses impacted by Affordable Care Act’s health coverage mandate

More than 90% of surveyed Michigan Medicaid recipients reported easier access to primary care in 2012

Survey results released today by the Center for Healthcare Research & Transformation (CHRT) show that Michigan Medicaid recipients said that they found it easier to get primary and specialty care appointments in 2012 than they did in 2010. In fact, their level of reported ease was comparable to those with employer‐sponsored coverage.

In the survey of 1,018 Michigan adults, more Michigan residents—both insured and uninsured—responded that they had a primary care provider compared to 2010. Medicaid recipients reported the greatest increase, rising to 88 percent in 2012 from 72 percent in 2010.

Read moreMore than 90% of surveyed Michigan Medicaid recipients reported easier access to primary care in 2012

Report: Michigan could save nearly $1 billion over 10 years by expanding Medicaid eligibility

A report released today by the Center for Healthcare Research & Transformation (CHRT) in partnership with two economists at the University of Michigan shows that the State of Michigan could save nearly $1 billion over 10 years—while extending comprehensive health insurance to more than 600,000 Michigan citizens—if the state expands Medicaid eligibility beginning in 2014 as provided for under the Affordable Care Act.

The U.S. Supreme Court’s June 2012 decision largely upheld the constitutionality of the Patient Protection and Affordable Care Act (ACA), but a provision that would financially penalize states that opted out of the law’s Medicaid expansion was not upheld, leaving the decision to individual states whether or not to expand Medicaid eligibility to individuals at or below 138 percent of poverty. In 2012, 138 percent of federal poverty level for a family of four is $31,809.

Read moreReport: Michigan could save nearly $1 billion over 10 years by expanding Medicaid eligibility

Report: Initial grant funding from Affordable Care Act went toward building workforce, health centers and other efforts to increase access to care

The Center for Healthcare Research & Transformation (CHRT) today released an issue brief showing that through the end of the 2011 federal fiscal year, Michigan organizations have received more than $82.5 million in grant funding under the Patient Protection and Affordable Care Act (ACA), placing Michigan among the top 15 states.

The majority of the funding was targeted to workforce building, helping the state educate and train more nurses and physicians. Other funding has gone to community health centers, community-based disease prevention programs, and programs to help the state prepare for changes coming to the health insurance market. The funding is helping Michigan prepare for the increased number of people expected to have health insurance, particularly Medicaid.

Read moreReport: Initial grant funding from Affordable Care Act went toward building workforce, health centers and other efforts to increase access to care

Medicaid changes under the Affordable Care Act will simplify enrollment, reduce number of uninsured in Michigan

The Center for Healthcare Research & Transformation (CHRT) released a policy paper that shows how the Patient Protection and Affordable Care Act (ACA) in 2014 will streamline eligibility categories and may also help between 400,000 and 500,000 citizens to become newly eligible for Medicaid coverage. Currently, there are at least 40 different ways—each with varying eligibility requirements—to qualify for Medicaid in Michigan.

Whether or not Michigan decides to expand coverage for Medicaid, the paper shows that enrolling in Medicaid and maintaining that coverage should become easier for Michigan residents starting in 2014, when the ACA requires states to eliminate asset tests—a review of an individual’s assets to ensure they do not exceed certain limits—and consolidate existing eligibility categories.

Read moreMedicaid changes under the Affordable Care Act will simplify enrollment, reduce number of uninsured in Michigan