Pharmacy Benefit Managers (PBMs): A brief for legislators
Pharmacy Benefit Managers (PBMs) are powerful intermediaries between drug manufacturers, pharmacies, insurers, and patients. They negotiate rebates and manage prescription benefits for nearly all Americans with drug coverage. While PBMs were created to streamline claims and control costs, concerns have grown about opaque pricing, market concentration, and their impact on patients and independent pharmacies. Key Findings 1. What PBMs do …
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The 340B drug pricing program in Michigan: A brief for legislators
The federal 340B Drug Pricing Program allows safety-net providers to buy outpatient drugs at reduced prices and reinvest the savings to serve low-income and uninsured patients. In Michigan, hospitals, clinics, and community health centers use these funds to sustain vital services—from behavioral health and maternity care to discounted prescriptions. While widely used, the program continues to draw debate around transparency, …
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Certified Community Behavioral Health Clinics in Michigan: Expanding Access to Behavioral Health Services
The Michigan Certified Community Behavioral Health Clinic (CCBHC) Demonstration is an initiative designed to expand access to community behavioral health services and improve Medicaid reimbursement. Michigan joined the federal Demonstration on October 1, 2021, with 13 initial sites, following authorization by the CARES Act of 2020. The program was later extended to a six-year demonstration, set to end in September …
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Access to health care in Michigan: A brief for legislators
The Center for Health and Research Transformation (CHRT) has released an issue brief focused on access to health care. The brief, titled “Access to Health Care in Michigan,” describes barriers that affect health care access in the state. Health insurance coverage is a central element improving access to care, but insurance coverage alone is not sufficient to ensure access. This …
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85% of Michigan physicians blame admin burden for rising stress and burnout
Physician burnout is a critical issue threatening both the stability of Michigan’s healthcare workforce and the quality of care that Michiganders receive. It is also a driving force behind staff turnover and decreased productivity in the state. These issues extend beyond staffing concerns, impacting both the quality and experience of care. Research has found clear links between physician burnout and …
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When Doctors ask patients about social needs, do they know where to send patients for help?
Since 2018, the Center for Health and Research Transformation (CHRT) has been surveying primary care physicians (PCPs) across Michigan about their experiences screening patients for health-related social needs and referring them to community-based resources for support. In this report, we examine how social needs screening and knowledge about where to refer patients has changed from before the pandemic (2018), to …
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The benefits of dental health
Increasingly, researchers are illuminating the benefits of dental health. Oral health impacts overall health and dental care is vitally important to curb chronic conditions and improve the systemic health of patients. In this publication by CHRT and Blue Cross Blue Shield of Michigan, CHRT’s health policy team analyzes peer-reviewed clinical research to understand the benefits of dental health for whole …
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Michigan Medicaid: A primer
Michigan’s Medicaid program provides health insurance coverage for many low-income children and adults. It is a powerful tool for improving the health of Michiganders. In June 2024, over 2.6 million of Michigan’s 10 million residents were enrolled in Medicaid: 1.7 million adults and 946,314 children. Most of Michigan’s Medicaid costs —over 65 percent in 2024—are paid for by the federal …
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Healthcare workforce shortages in Michigan: Recommendations for recruiting and retaining talent
Like the rest of the nation, Michigan is experiencing severe workforce shortages, exacerbated by the COVID-19 pandemic. One 2023 survey showed that 86 percent of physician practices in the state reported declines in staff since the COVID-19 pandemic and another showed 27,000 hospital job openings in early 2023 – a 13 percent vacancy rate. Nearly all health roles are expected …
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Supporting direct care workers in Michigan: Strategies from other states
Direct care workers (DCWs) provide long-term care services to vulnerable populations—largely older adults and people with disabilities—and often help keep people in their homes. Medicaid is the largest payer for long-term care services, many of which are provided by DCWs. According to the 2024 Michigan Healthcare Workforce Index, Michigan’s home health aides, personal care aides and nursing assistants have some …
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