Data from the Center for Health and Research Transformation’s (CHRT) 2018 Cover Michigan Survey show health benefits that Michiganders with health insurance coverage have used in the past year 1. Detail on the Cover Michigan Survey and analysis methodology can be found on CHRT’s website. In addition to findings on overall use of health care benefits, this brief focuses on three key areas: dental and vision, reproductive health, and mental health care. A full analysis can be found here.
Nearly all Michiganders used some kind of health benefit over the last year. To understand differences in the use of health care benefits, several variables were examined, including gender, age, race, insurance type, income, and employment status.
- Preventive care: The highest utilized benefit was routine, preventive primary care This was consistent across all groups.
- Dental and vision care: There is high use of these benefits even though they are not generally core offerings of most insurance
- Reproductive health care: Women, especially younger women, use these benefits at a significantly higher rate than men and older Reproductive health care represents 11 percent of younger women’s health care utilization.
- Mental health care: Younger women and people who are unemployed reported significantly higher use of their mental health care or substance use
Other findings include:
- Aside from dental and inpatient care, women consistently utilized more health care benefits than men.
- African Americans were the least likely to visit a doctor and use vision care benefits compared to other races, while white Michiganders were the most likely to use inpatient
- Regardless of insurance type, respondents use doctor visits at similar rates, however: those with employer-provided insurance were the most likely to use dental care benefits;
Medicaid beneficiaries had the highest utilization of pediatric care, contraceptive/family planning, mental health/substance use, and maternity/newborn care benefits; and Medicare beneficiaries made the most use of the prescription drug benefit. These differences are likely due to the unique populations that make up membership in these plans.
- Compared to those with lower household income, Michiganders with incomes of $50,000 or more per year were far more likely to use dental care, doctor visits, and vision
- The unemployed population was more likely to use inpatient care, mental health/substance abuse services, and maternity/newborn care than those who are working/in school or
Overall Use of Health Care Benefits
Overall, 96 percent of participants reported using at least one health benefit in the last year. More than 80 percent of participants reported use of doctor visits for preventive and wellness services; around three-quarters reported using
dental care; and two-thirds reported using vision care and prescription drug services. The least utilized benefits were pediatric care, family planning, mental health/substance use services, and maternity/ newborn care. FIGURE 1
Dental and Vision Benefits
Unlike other benefits highlighted in this brief, dental and vision coverage are usually purchased separately from core health insurance offerings. Our data indicate that these are very.
important, highly used benefits Overall, more than three-quarters of respondents reported using dental care and two-thirds reported using vision care. FIGURE 1 While these services are important to Michiganders, there are disparities in use—primarily by the type of insurance FIGURE 2 and household income FIGURE 3.
Reproductive Health Benefits
Even though these services are among the least-used health benefits overall, women are significantly more likely than men to report using reproductive health- related benefits (contraceptive/ family planning and maternity/ newborn services) either for themselves or for a covered family member. Overall, these benefits make up 5 percent of total health care utilization. Younger women (aged 18–49) are the most likely to utilize reproductive benefits. Nearly half of them used these services in the past year, which makes up around 11 percent of their utilized services. FIGURE 4 Younger women would be disproportionately affected by any policy changes that reduce access to covered reproductive health benefits. FIGURE 5
Mental Health Benefits
While mental health and substance use services are one of the least utilized benefits in the general population, nearly a quarter of both younger women (aged 18–49) and the unemployed population used these benefits in the last year. FIGURE 6 Mental health services can often be among the most difficult services to access,2,3 and this may be especially relevant for the unemployed population, who may be more in need of these services than those who are able to work or are retired. FIGURE 7 Those with a greater need for mental health services may have a harder time maintaining work.
Among those with coverage in Michigan, nearly everyone used at least one of their benefits. Primary/routine care is highly used, and dental and vision benefits, although not offered in core insurance packages, are highly utilized, indicating how important these benefits are for those who have this coverage
Mental health and reproductive health are used less, compared to other covered benefits, and there are also significant differences in who is using these services. Efforts to change access to these benefit offerings will disproportionately affect specific groups, in particular younger women and the unemployed.
Future briefs will look at access to care for covered benefits and will explore how access affects use of those benefits.