Publications

Medicaid

Cartoon drawing of several hands stacked over each other, symbolizing the public-private partnership behind Patient-Centered Medical Homes

Creating Sustainability through Public-Private Partnerships: The Future of New Primary Care Models

As the U.S. health care system places a growing emphasis on improving the value of health care, many states and the federal government have increasingly invested in primary care to improve health outcomes and lower health care costs. Unlike “traditional” primary care settings, newer primary care models strengthen primary care providers’ role in expanding access to care and providing comprehensive, …

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A primary care team in scrubs or white coats, arms folded.

Primary Care Teams in Michigan

Primary care teams have become increasingly important in the management of patients with complex chronic care needs. Data from the Center for Healthcare Research and Transformation’s 2016 Michigan Physician Survey show the proportion of primary care physicians (PCP) with primary care team members. Nearly half of PCPs had a care manager or nurse practitioner, while less than one-tenth had a …

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Female helping a male with his meal

Revisioning the Care Delivery Team: The Role of CHWs within State Innovation Models

The Affordable Care Act (ACA) promoted the broader use of Community Health Workers (CHWs) through a number of initiatives designed to reward health outcomes and value rather than paying providers by volume. One prominent ACA initiative under the Center for Medicare and Medicaid Innovation (CMMI) was the State Innovation Model (SIM) grants to states to design and test new payment …

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Medicaid and Medicare stamped on a paper with some pills

Changes in Payer Mix for Michigan Primary Care Physicians: The Impact of Medicaid

After Michigan’s Medicaid expansion, the state’s Medicaid population increased from 1.95 million in March 2014 (19 percent of the population) to 2.4 million in December 2016 (24 percent of the population). As a result, Medicaid has become a substantial part of Michigan primary care physician (PCP) practices. Policy changes related to Medicaid should take into account the breadth of impact …

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Map of Great Lakes

The impact of the ACA on community mental health and substance abuse services: Experience in three Great Lakes states

The Affordable Care Act (ACA) allowed states to expand Medicaid coverage to low-income childless adults, many of whom receive specialty mental health and substance use services through community mental health systems.  Leading up to the passage of the ACA, community mental health providers and their professional associations were generally supportive of expanding Medicaid under the ACA.  Medicaid covers specialty services …

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Patient in hospital bed looking at person filling out her chart

Decrease in Hospital Uncompensated Care in Michigan, 2015

The Affordable Care Act (ACA) expanded access to health insurance coverage for Michigan residents in 2014 through the creation of the Health Insurance Marketplace and the expansion of the Medicaid program. Since then, Michigan has experienced large decreases in the number of adults who lack health insurance, delay necessary care, and have trouble paying their medical bills.[footnote]E. Austic, E. Lawton, …

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Nurse looking at table and using calculator

Hospital Uncompensated Care in the United States, 2015 – Comparison of Midwest States

Since the launch of health insurance coverage expansion in 2014 under the Affordable Care Act (ACA), Michigan and other states have experienced large decreases in the number of adults who lack health insurance, delay necessary care, and have trouble paying their medical bills.[footnote] Austic, E. Lawton, M. Slowey, M. Riba, and M. Udow-Phillips, Changes in Health Care Cost Barriers under …

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Male and female working with paperwork of charts and graphs

American Health Care Act: Michigan Impacts

According to the Congressional Budget Office (CBO), the American Health Care Act would have differential impacts on individuals depending on factors such as age, income, geographic location, plan choice, and overall health. In general, the CBO concluded that people who are older, sicker, or receive their coverage through Medicaid will likely see higher costs or lower levels of benefits, while …

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A scale with medication on one side and money on the other

Changes in Health Care Cost Barriers under the Affordable Care Act in Michigan

The Affordable Care Act (ACA) not only significantly expanded access coverage starting in 2014, but also sought to improve access to services by reducing cost barriers to care and requiring coverage of certain “essential benefits”. For example, the ACA established patient annual out-of-pocket cost maximums; eliminated patient cost sharing for certain preventive care services; and prohibited annual and lifetime limits …

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Churning water

Insurance Churning

The uninsured rate has declined substantially since provisions of the Patient Protection and Affordable Care Act (ACA) came into effect. Nevertheless, many individuals continue to experience instability in insurance coverage. Transitions between different insurance plans, as well as between insured and uninsured status, are often referred to as “insurance churning.” The causes of insurance churning vary. Changes in job status …

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