In The Media Archive

MLive quotes Jaque King and Robyn Rontal on how the pandemic is galvanizing shifts in how we care for the elderly

MLive’s Julie Mack quotes Jaque King, lead healthcare analyst at the Center for Health and Research Transformation (CHRT), and Robyn Rontal, CHRT’s policy analytics director, in “COVID-19 pandemic hit seniors hard. Could it lead to a rethinking of how we care for the elderly?” The article describes how the COVID-19 pandemic brought to light many chronic problems in the way our health care system cares for the elderly.

King discusses research CHRT conducted on how nursing homes responded to the pandemic. “There’s really a clear need to care for and support staff,” she said. “During our study, we heard a lot of issues around being undervalued and underpaid, and about the need for training and education going forward.” In addition, “staffing levels are really important to keeping nursing home residents safe,” said King. “Those are the kinds of challenges the pandemic really highlighted and brought to light.”

Rontal notes that the pandemic is galvanizing a shift to home-based care. For years, Rontal says, there has been a movement “to find ways to shift care to the home with supportive services. There are a lot of good examples [of innovative] programs and polices that are starting to test that approach,” she says. “But I think the pandemic shone a spotlight on the need for better services in the home.”

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Detroit News quotes Terrisca Des Jardins on whether hospital price transparency provides meaningful information

In a Detroit News article by Karen Bouffard, Price shopping in Michigan proves difficult despite new rule for hospital costs, Terrisca Des Jardins, the executive director of the Center for Health and Research Transformation (CHRT), discusses the complexity of hospital price transparency.

Since January 1, hospitals have been required to publish their discounted cash prices and the prices they have negotiated with insurance companies for 300 medical services. Supporters of hospital price transparency hope the publicly available price information will help consumers make decisions as well as reduce prices by creating competition between hospitals.

However, pricing information at hospitals is complex and difficult to compare. Some hospitals include doctor fees in their prices, for instance, and some don’t. Hospitals may offer different versions of procedures with different aspects included. Adding complex medical language makes the pricing information even more difficult for consumers to understand. Consumers find it difficult to evaluate pricing and make knowledgeable decisions about their healthcare options due to all of these factors.

“Our biggest concern is whether price transparency is going to provide meaningful and actionable information to consumers about what the actual cost of their care is,” Des Jardins said. “And unless there is a clear and consistent process for translating and comparing price data, it may be confusing to consumers.”

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No evidence of transmission between COVID-19 patients in nursing homes

Covid test strip reads positive On March 12, 2021, PolitiFact reported on the criticism surrounding Michigan Gov. Gretchen Whitmer’s nursing home COVID-19 policies. Clara Hendrickson and Kristen Jordan Shamus reported that under Gov. Whitmer’s administration’s policies, elderly patients with COVID-19 were released back to their long-term care facilities or to nursing home hubs designated for COVID-19 patients. The Michigan Republican Party has said that this policy caused the deaths of other seniors in nursing homes.

In the article, Hendrickson and Shamus cite a Center for Health and Research Transformation (CHRT) report that showed no evidence of transmission between COVID-19 patients admitted from hospitals to nursing home hubs. CHRT did, however, find that the overall COVID-19 death rate was lower (17% vs. 26%) at nursing homes that were classified as regional centers than at nursing homes that weren’t. Non-hub facilities admitted more than twice as many COVID-19 patients in recovery during the course of the study period.

CHRT’s findings do not mean that there wasn’t the transmission, emphasized Udow-Phillips. But Udow-Phillips suggested that COVID-19 may have been transmitted from staff to residents, instead of between residents. “Most of the national data has supported this observation that it’s the transmission from the community into nursing homes,” she said.

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Michigan’s mental health system is a complex web, not an easy system to navigate writes Crain’s Detroit citing CHRT

In “State of confusion: Michigan’s mental health system has many layers for those in need to navigate,” Chad Livengood of Crain’s Detroit describes Michigan’s complex and daunting mental health system. Livengood notes that the system is facing financial hardships due to its complexity, as well as the huge financial hit caused by the COVID-19 pandemic itself.

COVID-19 has delayed state plans to improve the mental health system and provide more resources for those with severe mental health issues (SMI). Individuals with SMI often find themselves lost in the medical system, or the ER, instead of getting adequate mental health treatment from the proper organizations.

Livengood writes that when mental health facilities do receive funding from the Michigan Department of Health and Human Services, those funds tend to come with a long list of requirements that cost money to implement.

Certified Community Behavioral Health Clinics (CCBHC) are designed to address this issue by integrating primary care with mental health treatment. Experts hope that integrated health networks like these will dramatically improve the state’s mental health system.

Livengood cites the Center for Health Research and Transformation’s recent brief on CCBHCs, which notes that there are 18 CCBHCs across the state, and none in the northern Lower Peninsula and Upper Peninsula.

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Bloomberg cites CHRT’s nursing home policy research; argues that criticism of the Whitmer Administration is unfounded

Female health care worker speaking with male patient

In a Bloomberg News article, Republicans Seize on Nursing-Home Deaths to Weaken Democrats, David Welch and Gabrielle Coppola quote Marianne Udow-Phillips discussing the Center for Health and Research Transformation’s (CHRT) recent research on Michigan’s nursing-home policies during the COVID-19 pandemic.

Michigan Republicans have asked the state’s attorney general to investigate how Governor Gretchen Whitmer handled nursing home policy during the early stages of the pandemic. This is part of a nationwide pattern of Republican lawmakers criticizing Democrats for their handling of the pandemic, and specifically for the rates of deaths in nursing homes.

Welch and Coppola argue that these accusations are unfounded. In the case of Governor Whitmer’s policies in Michigan, they observe that CHRT’s research into nursing home policies in the state found no major problems. Overall, CHRT discovered that Michigan’s hub concept worked successfully. In Michigan’s nursing home hubs as compared to non-hub nursing facilities, the percentage of COVID-19-positive residents who passed away was significantly lower. This research, conducted by Cristin Cole, Erica Matti, Robyn Rontal, Jaque King, and Marianne Udow-Phillips, evaluated Michigan’s COVID-19 nursing home strategy and made recommendations for improvements.

Udow-Phillips told Bloomberg, “I hear these allegations [against Governor Whitmer] and ask, ‘Where is the evidence?’ There is no evidence. We found the governor’s strategy to be reasonable and appropriate, especially at the time.”

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Fox 17 Interviews CHRT Health Policy Analyst Ryan Bartholomew about special open enrollment period

Clipboard holding paper that reads Special Enrollment Period

From February 2020 to May 2020, there was a 46 percent increase in uninsured Michiganders due to residents losing their jobs during the early days of the pandemic. This means about 834,000 Michiganders newly found themselves without insurance. Via executive order, President Biden enabled the federal government to reopen the ACA Health Insurance Marketplace for a special enrollment period from February 15th-May 15th “for those who didn’t sign up for healthcare during the fall open enrollment period, or lost their private insurance during the pandemic.”

In a Fox17 interview, Doug Reardon talked with CHRT Health Policy Analyst, Ryan Bartholomew about what the special enrollment period for ACA insurance would mean for Michiganders.

Bartholomew emphasizes that having health care coverage can save Michiganders dollars: “Just being hospitalized for COVID-19 can c[ost] tens of thousands of dollars and having health insurance can be what prevents individuals and families from going bankrupt.” This special open enrollment period will extend access to affordable health care.

“Nine-in-ten Michiganders qualify for additional support and subsidy through the exchange,” says Carrie Kincaid, vice president of individual markets for Priority Health. Many people will get help paying for their premiums, “plus you could qualify for the Healthy Michigan program or Medicaid expansions.”

For more information on marketplace rates, read CHRT’s Rate Analysis: 2021 ACA Health Insurance Marketplace for Michigan or go to www.healthcare.gov.

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CHRT Health Policy Fellow Dr. Renu Tipirneni calls for bold policy action to address disparities in COVID-19

There are significant disparities in U.S. COVID-19 cases and deaths, but the underlying mechanism of these disparities remains unknown, says Health Policy Fellow Dr. Renuka Tipirneni. Tipirneni is a co-author of a cross-sectional study, published this month in JAMA Open, on the social and demographic factors most closely associated with COVID-19 incidence and death.

In this study, Dr. Tipirneni and coauthors investigated associations between county-level social risk factors and COVID-19 incidence and death using publicly available data sets, including the U.S. Centers for Disease Control and Prevention’s Social Vulnerability Index (SVI). The Centers for Disease Control and Prevention created the Social Vulnerability Index (SVI) to offer a composite measure of community sensitivity to challenges in the face of health shocks, including disease outbreaks.

The group found that “a wide range of social factors, including socioeconomic status, racial/ethnic minority status, family or household composition, and environmental factors, were significantly associated with COVID-19 incidence and mortality, which are also largely considered the driving forces associated with the racial/ethnic and social disparities that are already apparent in the COVID-19 pandemic in the US.”

“To truly bend the curve of disparities in COVID-19 and any future epidemics or pandemics,” write the authors, “these social risk factors and their root causes must be addressed through bold policy action and societal investment.”

CHRT Health Policy Fellow Mark Peterson argues for more support for adults with cerebral palsy and other childhood onset disabilities

Photo of Dr. Mark Peterson Dr. Mark Peterson, one of CHRT’s 2019 health policy fellows, is in Mayo Clinic Proceedings with “Cerebral palsy grows up,” arguing that more support is required for individuals with cerebral palsy (CP) and other childhood-onset disabilities as they grow up.

The population of adults with childhood onset disabilities has increased significantly, writes Peterson. While there is very little research on this population, we do know that adults with cerebral palsy have shorter lifespans, mainly due to physical and psychological morbidities.

“While publication of more scientific research pertaining to the health of adults with CP across the lifespan will improve the state of the literature to inform evidence-based clinical practice, a more pressing issue is the complete lack of coordinated care and public assistance for this critical transition period [when children with CP become adults],” writes Peterson.

Peterson recommends that medical establishments develop systematic, coordinated care options for these populations.

In addition, he writes, “We must fund federal navigators with priority training to assist our young adults with disabilities and their caregivers… to identify the necessary health care coverage and medical specialists that children with disabilities who are transitioning to adulthood need.” Peterson emphasizes that these navigator groups should include people living with disabilities themselves.

“As people with CP and other childhood-onset disabilities grow up, we have a unique opportunity and obligation to help them live well,” Dr. Peterson concludes.

Detroit Free Press quotes Terrisca Des Jardins on the unintended consequences of hospital price transparency

In a Detroit Free Press article, Trump rule forces Michigan hospitals to reveal secret prices, JC Reindl quotes Terrisca Des Jardins on the potential consequences of hospitals’ price transparency.

New rules, which took effect Jan. 1, require hospitals to disclose the rates they have negotiated with insurers–information that was previously secret. Most hospitals in southeast Michigan have complied. The Free Press found significant differences in the price of procedures between hospitals and between insurers at the same hospital.

Supporters of the hospital price transparency rule believe price transparency will lower healthcare costs. For instance, an insurance company may demand a reduction from a hospital if it discovers that it is paying more than a competitor. Des Jardins, however, warns, “There is not yet enough evidence that shows that price transparency will indeed lower costs. Sometimes, these types of efforts have unintended consequences.”

The American Hospital Association opposed the disclosures, contending that hospitals are too overwhelmed currently with COVID-19 treatment and vaccine administration. They have asked President-elect Joe Biden’s transition team to roll back the rules. The association’s CEO Richard Pollack highlighted that hospitals should focus their time and resources on delivering patient care and giving vaccines rather than being overburdened with additional requirements.

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An all-star zoom tribute to Marianne Udow-Phillips, founding executive director of CHRT

Marianne Udow-Phillips served as director of Michigan’s Department of Human Services during Jennifer Granholm’s Administration and as a senior executive at Blue Cross Blue Shield of Michigan for over 20 years before becoming the founding executive director of CHRT in 2007.

To commemorate Marianne’s retirement from the executive director role, and to pay tribute to her many contributions to health across the state and nation, we’ve prepared a special zoom tribute with an all-star cast of colleagues, partners, and friends.

Marianne Udow-Phillips will continue to serve as an advisor to CHRT and support the success of a number of client projects after she retires from the executive director role at the end of December.

“We are deeply grateful to Marianne, as she has led the implementation of CHRT’s mission, vision, and values, leading to sustained success,” says CHRT Board Chair Tony Denton, chief operating officer of the U-M Health System, Michigan Medicine.

“Her leadership and vision to advance non-partisan, evidence-based policy and assure access to care for all, improve population health, and advance social justice have had an enormous impact in Michigan and beyond.”

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