In The Media Archive

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

As the Coronavirus outbreak continues to disrupt global supply chains, many industries are feeling the impact of these disruptions. Pharmaceutical manufacturing is among the industries that could be affected. The closure of factories in China and India could result in drug shortages in the United States.

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

What’s new at CHRT: New projects that focus on integration, work requirements reporting, and mental health

The Center for Healthcare Research and Transformation’s (CHRT) latest e-newsletter brings some exciting updates and insights from our ongoing research and projects. This edition features findings from our recently completed research on behavioral health workforce challenges in rural communities and how states are addressing them. It also highlights our ninth cohort of health policy fellows, who are working on various policy projects across the state of Michigan.

One of the new projects that CHRT is working on is focused on integration, which involves collaborating with stakeholders to promote and improve integrated care models. Another project focuses on work requirements and how they impact Medicaid beneficiaries in Michigan.

In addition, the e-newsletter features a blog post from our director of research and evaluation on what we’ve learned during ten years of surveying Michiganders about health care coverage. It provides insights into the state’s progress towards achieving universal coverage and the challenges that remain.

The newsletter features information about CHRT’s Cover Michigan project, which has been surveying Michigan residents about their experiences with health care coverage for over a decade. The project has been instrumental in providing data and insights to policymakers, advocates, and stakeholders working to improve access to health care in Michigan.

Overall, CHRT’s latest e-newsletter provides a glimpse into the organization’s ongoing efforts to address pressing health care issues and improve access to care for all.

Read our February 2020 e-newsletter to learn more

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

Financial Graph

The MHEF (Michigan Health Endowment Fund) has released a directory of evaluation partners to provide evaluation services to health-oriented organizations in Michigan.

“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.

In summary, the Michigan Health Endowment Fund has recognized the importance of evaluation in informing decision-making and ensuring the effective use of resources in health-oriented organizations in Michigan.

READ THE FULL EVALUATION HERE

Related content:

Nancy Baum on what backbone organizations do, and why they matter

Ten years in, Riba on the legacy and future of Cover Michigan

Building a business case for sustainability–why you need one, and why this is the time to get started

Ninth cohort of CHRT Health Policy Fellows features diverse views, backgrounds, expertise, and more

On January 30, the ninth cohort of CHRT Health Policy Fellows will begin a four-month curriculum designed to build bridges between Michigan’s health researchers and policymakers. The curriculum includes the history of health care in America, Affordable Care Act implementation and impact in Michigan, value-based insurance design, Michigan Department of Health and Human Services priorities, collaborative quality initiatives, health care costs, and more. Many of the sessions are led by outside experts, including senior administrators at the Michigan Department of Health and Human Services and nationally regarded experts in health policy.

Fellows meet in Ann Arbor for seven, day-long seminars on public health policy and current issues affecting health policy and practice in Michigan and across the nation; take experiential learning trips to Detroit, Lansing, and Washington, DC, to see health policy and practice in action; and hear from health communicators and legislators about effective advocacy strategies. The CHRT Health Policy Fellows also work collaboratively on projects designed to translate new research findings for use by policymakers and practitioners.

This year, for the first time, the fellowship class will include leaders from the non-profit sector. The inclusion of policy fellows with non-profit experience is designed to further expand the perspective of the class and reflect the growing importance and increased interest of the non-profit sector in health care policy.

“The CHRT Health Policy fellowship creates a unique, multi-disciplinary environment that promotes deep learning and innovative thinking across the health care, public policy and non-profit sectors,” said Marianne Udow-Phillips, CHRT Director. “The enhanced training and connections created through the Fellowship strengthen the ability of leaders in all three sectors to have a positive impact on the health of people and communities.”

The 2020 CHRT Health Policy Fellows are:

Denise Anthony, Professor of Health Management and Policy, University of Michigan School of Public Health

Chardae Burton, Legislative Analyst, Michigan Department of Health and Human Services

Ramiro Galván, Chief of Staff, State Senator Winnie Brinks (D-Grand Rapids, MI)

Cassidy Giltner, Legislative Assistant, State Senator Michael MacDonald (R-Sterling Heights, MI)

Jeremy Glick, Legislative Director, State Representative Laurie Pohutsky (D-Livonia, MI)

Adrienne Lapidos, PhD, Clinical Assistant Professor, University of Michigan Medical School, Department of Psychiatry

Emily Toth Martin, PhD, Associate Professor of Epidemiology, University of Michigan School of Public Health

Michelle A. Meade, Associate Professor, University of Michigan Department of Physical Medicine and Rehabilitation

Lisa Peacock, Health Officer, Health Department of Northwest Michigan and Benzie-Leelanau District Health Department

Kait Skwir, Director of Policy and Special Projects, Food Bank Council of Michigan

Greg Toutant, Chief Executive Officer, Great Lakes Recovery Centers

Jen Villavicencio, MD, Clinical Lecturer, UM Department of Obstetrics and Gynecology

Samantha Zandee, Chief Policy Advisor, State Representative Brandt Iden (R-Portage, MI)

More information about the CHRT Health Policy Fellowship and complete biographies of all the 2020 CHRT Policy Fellows can be found at https://chrt.org/fellowship/.

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.

The article discusses the high cost of having a baby in the United States and the various factors contributing to it. It highlights the steep prices of prenatal care, delivery, and postpartum care, as well as the additional expenses of childbirth-related complications and premature births.

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.

The research by Moniz, Mark Fendrick, and others, discusses the increase in out-of-pocket spending for maternity care in the US from 2008 to 2015, despite the implementation of the Affordable Care Act (ACA). The proportion of women with any out-of-pocket spending increased during this period. The rise in out-of-pocket spending may lead to delays in or a lack of maternity care, which could result in health complications for both mothers and babies.

“The High Cost of Having a Baby in America” by Olga Khazan for The Atlantic also examines the role of insurance coverage, with many women facing high deductibles and out-of-pocket costs. The author emphasizes the need for policy interventions to address the issue and improve access to affordable maternity care for all women.

“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 THE FULL ATLANTIC STORY HERE

Ten years in, Riba discusses the history and future of Cover Michigan, launched to track ACA trends

Recently, our research and evaluation team sat down for a 2020 work-planning meeting, and we asked ourselves, “what did we want to accomplish in 2020?” As our conversation focused on the year ahead, it also led me to think about the last ten years of Cover Michigan – the issues and subjects we explored, and the impact that the survey has had.

The initial concept for Cover Michigan was to conduct a consumer survey that regularly explored health, health insurance, and health care access trends across Michigan.

We developed the concept in 2009 to better understand the likely impact of the Affordable Care Act on the state of Michigan and the people who live here. Over the last decade the survey has revealed important trends about health status, health care coverage, and access to health care across populations.

Some of the topics we asked people about included insurance churning and access, satisfaction with health coverage, and participation in wellness and prevention programs – and we learned a lot.

In 2013, we found that Michigan’s mental health care system faced significant capacity challenges.
In 2015 we learned that cost, not physician choice, was the most important factor for consumers selecting a health plan. And we also learned that race and economic status were strong predictors of whether people had a flu vaccination, and that Michigan had opportunities to improve vaccination rates.
In 2016 we found that a substantial share of Michiganders reported having participated in wellness programs – though they perceived limited benefit from those programs – and that those who participated in mental health and stress relief programs reported the greatest perceived benefits.

And of course, it’s always gratifying when a Cover Michigan Survey brief is part of a story in the media, whether it’s regional coverage of our mental health care access survey brief in Crains Detroit or national print stories mentioning our insurance churning survey findings in The Week or The New Republic.

This partial list of the useful information that has developed from the Cover Michigan survey really just scratches the surface of what we’ve learned and shared at CHRT over the last decade.

So the survey will continue, and expand.

In the next decade, we will maintain our emphasis on learning about the health of people and communities, and we will continue tracking trends in coverage and access to care.

But we will also increase our focus on the social determinants of health; use new platforms to disseminate what we learn through the survey; and work to expand statewide partnerships that help us provide local and regional health data to inform policy decisions that positively impact the health of people in communities all across Michigan.

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 THE CONSUMERS REPORT STORY HERE

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

Dr. Carrie Rheingans on ER helping Opiate Crisis.

Many parts of the world have been affected by the opiate crisis, which has devastating effects on individuals and their families. Michigan has been impacted by this crisis more than most other states in the United States. However, the state has implemented various strategies to combat the issue, with a particular focus on its 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 THE BRIDGE MICHIGAN STORY HERE

CHRT to support grantees of The Kresge Foundation as they advance health and human services integration

The Kresge Foundation has awarded $1.5 million in grants to five organizations across the nation to enhance their efforts to integrate their health and human services systems and create more seamless, person-centered experiences for individuals and families seeking support in cities across the country.

The Center for Health and Research Transformation serves as the foundation’s learning partner and technical assistance provider for the initiative.

Integrating health and human services systems requires changes to policies, practices, funding, data systems, values and culture, Katie Byerly, Kresge Health program officer said.

This includes implementing, aligning and improving data sharing systems; reallocating and blending health and human services funding streams; ensuring person-centered approaches; establishing shared values and goals; and creating strong and effective feedback loops for continuous quality improvement among partners.

See the Center for Health and Research Transformation’s Health and Human Services Integration Continuum and EVOLVE Model of Integration, developed for this initiative.
Read more about this initiative in the Health Affairs GrantWatch article, “Nine lessons for leaders of health and human services integration initiatives (and for the grantmakers that want them to succeed.”

“We believe that integrated systems move beyond crisis stabilization, triage, or treatment to accelerate social and economic mobility and health equity,” said Joelle-Jude Fontaine, Kresge Human Services senior program officer. “These systems should be informed by individuals and families and create equitable pathways to opportunity so that people and communities can thrive.”

With this funding, organizations will advance existing integration efforts that strengthen connections across health and human services systems to improve the health and well-being and the social and economic mobility of children and families.

Grantees include:

Alameda County Public Health Department, California
Arlington County Health and Human Services Department, Virginia
Hennepin County, Minnesota
Montgomery County Health and Human Services Department, Maryland
Solano County Health and Social Services Department, California

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

In many communities, the shortage of primary care doctors is becoming an increasingly serious concern. Among these areas is Lansing, Michigan, where a shortage of primary care physicians has resulted in long wait times and difficulty accessing healthcare.

“… the length of time it takes people to get into 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 doctors 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 healthcare needs, and “[W]hatever shortage patients feel now likely will get worse within the decade.,” writes Thompson. The article goes 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.”

It is evident that the shortage of primary care doctors in Lansing, Michigan presents a significant challenge to residents seeking health care. Long wait times and difficulty accessing health services can delay diagnoses and give poorer health outcomes. It is encouraging to see that efforts are being made to address the shortage. Primary care doctors play a major role in providing preventive care, managing chronic conditions, and coordinating medical care. To improve healthcare outcomes for all residents, we must address the shortage of these healthcare professionals.

READ THE LANSING STATE JOURNAL ARTICLE HERE

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