In The Media Archive

Joshua Traylor named executive director of the Center for Health and Research Transformation

Joshua Traylor, MPH, senior director at the Health Care Transformation Task Force in Washington, DC, has been named executive director of the Center for Health and Research Transformation (CHRT), an independent nonprofit policy center at the University of Michigan. Traylor will take the helm on November 1.

“The board was unanimous and enthusiastic about selecting Joshua Traylor for the role of executive director,” says Tony Denton, CHRT board chair and senior vice president and chief operating officer of the University of Michigan Health System – Michigan Medicine. “Traylor’s work with diverse stakeholders, his systemic approach to complex challenges, and his commitment to health equity will advance CHRT’s mission to inform and support policies and practices that improve population health.”

Throughout his career, Traylor has developed deep expertise in health care reform strategies and has led cross-sector work to extend care to the uninsured and to address barriers to successful reform efforts in Medicare, Medicare Advantage, Medicaid, state employee, and privately insured populations.

As a senior director of the DC-based Health Care Transformation Task Force, Traylor has worked with health care providers, purchasers, patient advocates, policymakers, and regulators to develop recommendations and resources for public and private sector payment and care delivery improvements. He has also worked with federal agencies and stakeholders and collaborated on a series of grants aimed at enhancing health equity, improving maternal health, involving patients and communities in health care decision-making, and addressing health-related psychosocial needs.

Prior to his role at the Task Force, Traylor was a member of the Prevention and Population Health Group and the State Innovations Group at the U.S. Center for Medicare and Medicaid Innovation. At the Innovation Center, Traylor worked on the design of the Integrated Care for Kids Model, developed financial models to forecast the impact of proposed care delivery and payment reforms, identified strategies and recommendations for Medicaid care delivery and alternative payment reforms, and worked with State Innovation Model awardees to implement Medicaid reforms.

“My first position after graduate school was as an early career fellow at CHRT working on data analytics and the Washtenaw Health Initiative. The fellowship experience was invaluable for me and continued to inform my work at CMMI and HCTTF,” says Traylor. “I am thrilled to have the opportunity to work with the talented CHRT staff, board members, and partners to further CHRT’s mission of improving the health of people and communities and to continue to develop future leaders in this space.”

“The board is deeply grateful to Robyn Rontal for her willingness to serve as interim director of CHRT, maintaining CHRT’s mission, vision, and values during this transition,” says Denton. “Her steady leadership has kept CHRT on course while improving its fiscal and operational position in important ways.”

CHRT’s 2021 impact report highlights the organization’s local, state, and national work to inspire evidence-informed policies and practices that improve the health of people and communities.

Introducing CHRT’s 2023 Rebecca Copeland Interns: Jennie Scheerer and Ashya Smith

We are pleased to announce that Jennie Scheerer and Ashya Smith have been chosen to serve as CHRT’s 2023 Rebecca Copeland Interns.

Jennie Scheerer will primarily work with CHRT’s health policy and research and evaluation teams. She is interested in the intersection between maternal and reproductive health, anti-racism, and U.S. domestic policy.

“Everyone with a uterus should have access to safe and equitable healthcare,” says Scheerer.

Before joining CHRT, Scheerer interned with the department of obstetrics and gynecology and the University of Michigan Institute for Healthcare Policy and Innovation (IHPI). As a research assistant, Scheerer helped manage research projects on abortion access and Title X family planning programs in Michigan.

Scheerer is a 2024 dual master’s candidate in public health and public policy at the University of Michigan. She holds a bachelor’s degree in human development and social relations from Kalamazoo College.

Ashya Smith is interested in Black maternal health care, health equity, reducing health disparities, and improving healthcare access. She graduated from the University of North Carolina – Chapel Hill’s Gillings School of Global Public Health, with a master’s in health policy in 2023.

While at the University of North Carolina, Smith interned for Birth Detroit and the United States of Care. In these roles, she learned how to use policy to advocate for marginalized communities. Smith also spent two years working on kidney policy research projects as a policy associate at the Arbor Research Collaborative for Health.

In 2019 Smith earned a bachelor’s degree from the University of Michigan in international studies, with a focus on global health and environment. During her undergraduate career, she interned at the Black Aids Institute as a UCLA Public Health Scholar, worked in sickle cell research in Ghana, and assisted in diabetes and food insecurity research at the University of Michigan School of Public Health.

About the Rebecca Copeland Memorial Internship

Rebecca Copeland was a dual degree student in public health and public policy at the University of Michigan, and graduated with an MPP and MPH in the spring of 2021.

“Rebecca was deeply committed to improving health, health care, and social justice,” says Terrisca Des Jardins, one of Copeland’s mentors and former executive director of CHRT. “She brought enthusiasm and excellence to analysis of important health policy issues and inspired those alongside whom she worked.”

Des Jardins describes Copeland as “a wonderful human being who brought excellence and critical thinking to everything she did. She was demanding of herself and others, and of society and health care delivery. She was thoughtful, kind and caring. She also had a wicked sense of humor.”

Copeland interned with Nancy Baum, CHRT’s health policy director, working on projects related to improving the public mental health system.

“Her energy was amazing,” says Baum. “Rebecca showed us just how valuable interns can be in an organization like ours. When an intern is both smart and dedicated to making systems better to improve health, as Rebecca was, they can move mountains,” says Baum.

Rebecca Copeland passed away in July 2021. CHRT and the RAC Fund for Social Justice honor her memory by offering the Rebecca Copeland Internship to graduate students at the Gerald R. Ford School of Public Policy.

CHRT welcomes four new team members

Since our last newsletter, CHRT has welcomed four new team members.

Jadrienne Horton

Jadrienne Horton is a project manager for CHRT’s research and evaluation team. Horton previously interned with the team through the American Evaluation Association’s 2022-2023 Graduate Education Diversity Internship program, assisting with the Year 1 Evaluation Report for the Washtenaw County Law Enforcement Assisted Diversion and Deflection (LEADD) pilot. Horton recently graduated with a dual master’s degree in public health and social work from the University of Michigan. She has interests in working with marginalized racial and ethnic minority groups and underserved populations to raise awareness about environmental and social injustices impacting their communities. She is also passionate about incorporating race equity into evaluation and research practices.

Abdullah Hashsham

Abdullah Hashsham is an associate analyst on the health policy and health and social equity teams at CHRT. He assists with the Washtenaw Health Initiative and works with the health policy team on Medicare, Medicaid, and long-term services and supports projects. Before joining CHRT, Hashsham was a research lab technician in the Affinati lab at the University of Michigan, studying diabetes from a neuroscience lens. Additionally, he interned at the Center for Healthcare Innovation, a Chicago-based non-profit, where he supported health equity initiatives on clinical trial diversity, affordable care, and children’s mental health. Hashsham earned his bachelor’s degree in public health from the University of Michigan.

Janan Saba Landsiedel

Janan Saba Landsiedel is a senior project manager at CHRT, supporting the objectives of the health and social equity team. She currently serves as the project manager for the Promotion of Health Equity initiative partnering with regional health organizations, Michigan Medicine, and the Michigan Department of Health and Human Services. Prior to joining CHRT, Saba Landsiedel supported quality improvement initiatives at Henry Ford Health. Additionally, she served as chair of the Michigan State Advocacy Committee for the American Heart Association. She holds a Master of Public Health with a concentration in global health from George Washington University, a bachelor’s degree in psychology from Albion College, and a professional certificate in project management.

Nailah Henry

Nailah Henry is an analyst on the health policy team at CHRT. She is committed to public health education, community health engagement, and advancing the understanding of health disparities. Henry has worked as an associate clinical research coordinator at Michigan Medicine and as a research assistant at Wayne State University and the University of Michigan. She holds a master’s degree and bachelor’s degree in public health from Wayne State University.

Regional Health Collaboratives work to improve behavioral healthcare

AI diagram of interconnected health images

The Promotion of Health Equity Project engages six Regional Health Collaboratives — care coordination programs designed to improve a region’s wellbeing – to address health-related social needs and establish a framework for statewide expansion.

A recent MI Mental Health Series article by Estelle Slootmaker, “Regional Health Collaboratives improving access to behavioral health services,” discusses the goals of these six collaboratives and specifically highlights MI Community Care (MiCC), the collaborative serving Livingston and Washtenaw Counties.

CHRT provides the administrative backbone for MiCC, and is also evaluating the progress of all six collaboratives. The article interviews two CHRT staff members: Ayşe Büyüktür, MiCC program manager, and Jonathan Tsao, senior project manager on CHRT’s research and evaluation team.

While the Regional Health Collaboratives help patients with a wide range of health and social needs — including housing, medication management, transportation to and from medical appointments, and food security — one of the collaboratives’ key objectives is to improve access to behavioral health care. To do so, each collaborative works with local partners to make behavioral health referrals.

Behavioral health is still stigmatized, Büyüktür says: “Not everyone is comfortable asking for help or knows how to access services … If someone is struggling with behavioral health needs, expecting them to navigate complex systems of care … places extra burden on them.”

“Most of the residents who come to their region’s programs have complex medical, behavioral health, and social needs,” says Tsao. “[Regional Health Collaborative] programs are designed to address all of those needs through care coordination.”

MiCC partners with Washtenaw County Community Mental Health (WCCMH) and Livingston County Community Mental Health.

To coordinate behavioral health care for a MiCC participant, the lead care coordinator arranges care and resources for patients, and community health workers (CHWs) and peer support specialists help patients access these resources.

CHWs and peer support specialists “meet participants where they are,” says Buyuktur. “They see their living situations. They have the expertise to recognize needs and problems … They are incredibly knowledgeable about community resources. And because they build strong, trusted working relationships with community members based on those individuals’ personal goals, they help to de-stigmatize behavioral health at the individual level.”

MI Mental Health interviews Ayse Buyuktur about the importance of community health workers

Female health care worker filling out chart of adjacent older female

CHRT’s Ayse Büyüktür, program manager for the MI Community Care (MiCC) program, recently spoke with MI Mental Health about the extensive work community health workers do to support the behavioral health needs of residents.

Across the state, community mental health agencies enlist community health workers to extend their reach, writes reporter Rylee Barnsdale in “Community health workers bring mental health home.”

Washtenaw County Community Mental Health, for example, partners with MI Community Care to provide CHW services.

MI Community Care works in both Washtenaw and Livingston counties, providing cross-sector care to support the needs of residents with complex lives and conditions. The story outlines how MiCC CHWs–centered at the Washtenaw Health Plan and the Livingston County Community Mental Health agency, support MiCC participants under challenging situations, helping them get the care and support they need.

One role of a CHW is performing home visits to patients to “meet them where they are,” Büyüktür explains. Home visits go beyond “simply helping to make appointments and phone calls,” she continues. During home visits, CHWs also can analyze what state an individual and their home are in and find community resources to improve their conditions, and to lessen feelings of social isolation.

When asked, “Are there changes for CHWs and how health care systems recognize them?” Büyüktür says Michigan “is working out how to pay CHWs who service people on Medicaid,” which is something she and others across the state are really excited about. To appropriately compensate CHWs for their work, though, requires understanding their value.

“[CHWs] do so much for us. It’s hard in some ways to describe it because they are changing lives. That’s not a cliche in this situation. It’s reality.”

CHRT explores the individual and environmental factors linked to healthy aging for people with long-term disabilities

An older person in a wheelchair touching tall grass

Since 2018, CHRT has worked closely with one of the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDLRR) rehabilitation research and training centers (RRTC). The project, Investigating Disability factors and promoting Environmental Access for Healthy Living (IDEAL), aims to promote healthy aging for people with long-term physical disabilities.

What we’ve done

For the IDEAL RRTC, housed within the University of Michigan’s Center for Disability Health and Wellness, CHRT has produced multiple articles and policy briefs that elevate challenges and solutions for individuals aging with long-term disabilities.

In a brief titled Housing crisis is magnified for people with physical disabilities. Here’s how we can help, CHRT describes how individuals with physical disabilities are impacted by the U.S. housing crisis and shares ways to make housing more accessible and affordable.

In another brief titled Telehealth for people with disabilities, CHRT recommends national and state policies to make telehealth more accessible, functional, and supportive for people with disabilities, such as incorporating closed captioning during appointments.

In a third brief, CHRT investigates policy and programmatic solutions for supporting family caregivers, and in a fourth, CHRT explores the additional stress COVID-19 has caused for unpaid caregivers, and why that matters.

And in a 2021 issue of the Annals of Family Medicine, CHRT staff Robyn Rontal, Jaque King, and IDEAL RRTC colleagues describe annual wellness visit (AWV) use among persons with physical disabilities from 2008 to 2016–before, during, and after the rollout of the ACA.

The Annals article, Annual wellness visits for persons with physical disabilities before and after ACA implementation, reports that while the rate of annual wellness visit use was decreasing before the inception of the ACA, that trend reversed when the ACA rolled out and the use of AWVs among persons with disabilities has continued to increase.

The analysis, however, also found stark differences in AWV use based on gender, race, and other factors.

In 2016, for example, commercially insured women with congenital disabilities had the highest rates of AWV use at almost 50 percent. However, Black and Hispanic men with congenital disabilities (commercially insured or Medicare Advantage members) had AWV utilization rates around half that. In addition, people with disabilities were 15 percent less likely overall to use annual wellness visits.

Recent accomplishments

More recently, CHRT fielded a national survey of disability and aging services organizations and shared findings in a webinar titled, Serving those aging with a long-term physical disability during the COVID-19 pandemic: Challenges, successes, and innovations.

Among the 138 organizations surveyed, close to half (48 percent) changed or cut services during the pandemic, and 85 percent reported that the success of their programs was challenged by financial constraints.

“Organizations play an important role to ensure people with disabilities can age successfully,” says Marissa Rurka. “It’s important to uplift their strategies and share what they did during COVID-19 and how they adapted to unprecedented times.”

During the webinar, Riba and Rurka facilitated a panel of representatives from four organizations. The Arc Detroit in Michigan, the Ability Center in Ohio, The League in Indiana, and the Thompson Senior Center in Vermont each discussed challenges that their organizations faced as a result of the pandemic.

Panelists discussed how they adapted to those challenges. They also shared opportunities to better serve those aging with physical disabilities.

In April 2023, findings from this survey were published in the peer-reviewed journal, Disabilities, in a special issue of the journal titled: Aging with disabilities.

The article, Organizations’ Perspectives on Successful Aging with Long-Term Physical Disability, describes the researchers’ methodology and results. Authors define successful aging for this population and which strategies and programs work well.

What we plan to do

CHRT policy staff are now conducting an analysis of dually-eligible (Medicare and Medicaid) members with a physical disability and tracking their utilization of annual wellness visits from 2007-2016.

“We will compare members from a sample of Medicaid expansion states to a sample of states that did not expand Medicaid in order to test the impact of Medicaid expansion,” says Jaque King, associate director of health policy at CHRT.

The team will look at other measures too, such as hospital admissions and emergency department visits pre and post-Medicaid expansion, to test the impact of Medicaid expansion.

Beyond this project, CHRT has also begun working with UM’s Center for Disability Health and Wellness, led by Michelle Meade, an associate professor in the University of Michigan Department of Physical Medicine and Rehabilitation, to launch an RRTC Equity Center.

The new equity center will foster collaboration between organizations and investigators. Participating investigators hail from organizations dedicated to enhancing the health and functioning of individuals with disabilities–particularly those from marginalized and underserved communities.

Collaborating organizations and researchers will analyze existing data, and will develop and evaluate new interventions to change the behaviors of health care providers and systems. CHRT will help center participants learn how to share their findings through policy engagement and advocacy.

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The project is funded through a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90RTHF0001). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS).

CHRT’s Interim Executive Director Robyn Rontal is one of the co-PIs.

Michigan’s CCBHCs open mental health access to all

Green felt brain next to green mental health awareness ribbon

CHRT’s work evaluating Michigan’s Certified Community Behavioral Health Clinics (CCBHCs) was highlighted in a Second Wave Media article, “Michigan’s CCBHCs open mental health access to all.” The article features interviews with CHRT team members Erica Matti, senior health policy analyst, and Jonathan Tsao, research and evaluation project manager.

CCBHCs provide whole-person care and aim to consider all aspects of a person’s health, including physical, emotional, and behavioral health, as well as social challenges such as financial and housing insecurity. To address these needs, CCBHCs provide a range of mental health and substance use disorder services to individuals, regardless of their income or insurance coverage.

There are 34 CCBHCs in Michigan, including Washtenaw County Community Mental Health. Of those CCBHC sites, 13 are demonstration sites, which are full-service clinics where anyone can walk in and receive services. The federal government provides 75 percent of the funding for demonstration sites; the other 25% is provided by the state.

The National Council for Mental Wellbeing (NCMW) 2022 CCBHC Impact Report showed that CCBHC status enables clinics to:

serve an average of 900 more people per year than they were able to serve before implementation and
increase hiring, with an average of 27 new staff per clinic hired as a result of being a CCBHC.

The report estimates that in 2022, 2.1 million people were served across all 450 active CCBHCs and grantees nationwide, a 600,000-person (29 percent) increase from 2021.

As the designation of demonstration sites in Michigan is relatively recent, there’s not yet been any Michigan-specific evaluations conducted on the CCBHC model. Michigan recently received federal funding for this purpose and partnered with organizations, including CHRT, to carry out the evaluations.

“There’s a number of findings that we’re really hoping to see in Michigan including improvements in staffing, training for staff, care, and care coordination,” says Erica Matti. “Care coordination is a huge one for the CCBHC model. the states that have had this for a long time have seen really good improvements in care coordination.”

Tsao outlined that the evaluations have three purposes. First, to understand why Community Mental Health (CMH) centers are implementing the CCBHC model, as well as their successes and challenges in doing so. Next, to deliver an outcomes evaluation of the impact on access to behavioral health services and sustainability. Finally, the evaluations will document lessons learned to help future CCBHC clinics.

Center for Disability Health and Wellness shares one-pager based on CHRT research

A doctor and a patient in a wheelchair look at a chart together.

In 2021, CHRT researchers co-authored an article, published in the Annals of Family Medicine, studying annual wellness visit (AWV) use among people with disabilities before and after the Affordable Care Act.

The article, written by Jaque King and Robyn Rontal from CHRT, broke down AWV use by gender, race, and other factors and shared the finding that people with disabilities were 15 percent less likely to attend AWVs than the general population.

This month, the Michigan Medicine Center for Disability Health and Wellness shared a one-pager with key findings from the article. The one-pager, “Did people with disabilities increase their use of annual wellness visits after the implementation of the ACA?” details the health disparities that still remain in the use of wellness visits.

READ THE ONE-PAGER

Nancy Baum quoted on mental health provider shortage

Young girl speaking to attentive therapist

As mental health needs surge, the demand for care in Washtenaw County far exceeds the number of providers available. In an article by Rylee Barnsdale, titled “How can Washtenaw County solve its mental health care provider shortage?” Concentrate quotes Nancy Baum, health policy director for the Center for Health and Research Transformation (CHRT).

The article discusses the growing need for behavioral health providers, both nationally and in Washtenaw County, noting that clinical mental health provider salaries average roughly $52,000 annually in Michigan, compared to $241,000 for psychiatrists. Thus, hiring behavioral healthcare providers is a challenge.

“Recruiting is one thing. Retaining is another,” says Baum. “And level of pay is a big part of that …”

It is not unusual these days for Washtenaw County Community Mental Health (WCCMH) to have dozens of open positions. Staff turnover is generally attributable to the fact that salaries are low, especially given the amount of emotional care required to support the community.

Trish Cortes, executive director of WCCMH, says that WCCMH has historically been “pretty competitive in terms of recruiting.” Cortes says WCCMH often attracts mission-driven staff, dedicated to helping the community.

Doug Campbell, CEO of the Ypsilanti-based nonprofit provider Hope Clinic, echoed these sentiments: “We’ve doubled down on mission and culture,” Campbell said. “We attract a particular person that is keen on the mission and culture that we live out.”

Read the article here

CHRT study cited in Second Wave article on long COVID impact on Michiganders

Woman at work, distressed due to face mask restricting breathing

As of May 2022, a CHRT study found that more than 700,000 Michiganders are living with long COVID, the lasting symptoms of COVID infection. Second Wave Media’s article “Researchers seek solutions for Michigan’s 700,000 COVID long haulers,” written by Estelle Slootmaker, cites CHRT’s research on long COVID and its impact on individuals, the state, and health care systems. The author interviews Jonathan Tsao, research and evaluation project manager at CHRT.

Among “COVID long-haulers,” common symptoms include brain fog, shortness of breath, heart palpitations, depression or anxiety, and digestive difficulties. As outlined in the CHRT study, these symptoms affect the professional lives of long haulers, resulting in major economic burdens for families.

“There was a significant difference between long haulers in their financial situation compared to [those who do not have long COVID],” says Tsao. “There are two main reasons for this. One is their decreased ability to work at a full capacity. They are more likely to work reduced hours, quit their jobs altogether, or get laid off — and they would be more likely to miss out on a promotion. And they have to deal with increased medical costs.”

As disability insurance does not cover long COVID, many employees face unfair workplace expectations without protection. Paired with the lack of research and awareness surrounding the condition, policy action may be needed to accommodate individuals dealing with long-term symptoms of COVID.

“We suggest policymakers increase awareness and make it easier for workplaces to make accommodations for long haulers,” Tsao says. “Long COVID is one of those outcomes that’s going to require more study and research to understand. Our health systems, research centers, and the National Institutes of Health are establishing programs specifically to look at the ongoing impacts of COVID and long COVID. The reality is that we don’t know a lot about the cause and effect.”

CHRT’S STUDY MAIN FINDINGS ARE:

More than one in every three of the Michiganders surveyed who reported a COVID-19 diagnosis identified themselves as COVID long haulers
Women and people with diabetes were more likely to report long COVID
The three most common symptoms of long COVID reported were breathing issues, lost or distorted sense of smell or taste, and lingering anxiety, depression, or other mental health issues

READ SECOND WAVE’S ARTICLE

READ CHRT’S BRIEF

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