Publications

Publications

Healthy Aging

covid-19, elderly, nursing

COVID-19 rapid response brief: Best practices for protecting populations in nursing homes, long-term care settings

Throughout the COVID-19 crisis, staff members at the Center for Health and Research Transformation (CHRT) have been conducting rapid response research for Michigan policy leaders who are working proactively to protect vulnerable communities across the state. In this analysis for the Michigan Department of Health and Human Services, we explore best practices for supporting populations in long-term care settings such …

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Managed long-term services and supports: Michigan Department of Health and Human Services research report

In the 2017-2018 state budget, the Michigan Legislature asked the Michigan Department of Health and Human Services to explore implementing managed long-term services and supports (LTSS). The department hired the Center for Health and Research Transformation (CHRT), Health Policy Matters, and Public Sector Consultants (PSC) to conduct an analysis of the state’s existing long-term services and supports system and to …

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Advance Care Planning: Tying a Community Perspective to the National Conversation

Advance care planning (ACP) is a process where people talk with family members and doctors about their end-of-life care preferences and designate someone to carry out their wishes. ACP helps people plan for future medical treatment in the event of a serious illness. Controversies associated with ACP—perhaps most famously the accusations of “death panels” that demonized the Affordable Care Act—have …

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Acute care readmission reduction initiatives: An update on major programs in Michigan

Inpatient hospitalizations account for 32 percent of the total $2.9 trillion spent on health care in the United States. In the majority of cases, it is necessary and appropriate to admit a patient to the hospital. However, patients returning to the hospital soon (e.g., within 30 days) after their previous stay account for a substantial percentage of admissions. Research has …

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Price transparency in health care: Federal and state initiatives, ongoing challenges, and opportunities for the future

In recent years, consumers have assumed an increasing share of health care spending through high deductible plans. For example, the average deductible for family coverage in Michigan more than doubled from 2002 to 2012, rising from $810 to $1,877, respectively. Deductibles for individual coverage in Michigan grew by 162 percent over the same period of time, increasing from $375 to …

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Affordable Care Act funding: An analysis of grant programs under health care reform

The Patient Protection and Affordable Care Act (ACA) was signed into law on March 23, 2010, and funds were appropriated to expand access to care, implement broad private insurance reforms, and enhance the public health infrastructure. In order to administer these new grant programs, the ACA created a number of new funding sources in the following categories: Community-based prevention: Includes …

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Commercial accountable care organization products: Market leaders and trends

In 2006, Elliott Fisher of Dartmouth coined the term “accountable care.” Accountable care arrangements are based on three principles: Accountability for quality: A group of providers is clinically and financially responsible for the entire continuum of care for a group of patients. Depending on the arrangement, providers, hospitals, and health insurers may share responsibility for the patients’ care. Shared savings: …

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Health care spending for chronic conditions in Michigan

Chronic conditions affect millions of Americans and have a major impact on U.S. health care spending each year, accounting for seven out of every ten deaths in the United States annually. It is estimated that more than 75 percent of all health care costs are associated with chronic diseases. Approximately 45 percent of Americans nationwide are affected by at least …

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Community mental health services: Coverage and delivery in Michigan

Michigan’s publicly funded mental health system has its origins in Public Act 54, signed in April 1963. This state law permitted counties to form Community Mental Health (CMH) boards to support and treat people with severe mental illness, developmental disabilities, and substance abuse disorders outside of psychiatric hospitals and institutions. The Act was intended to help states “provide for adequate …

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Best Practices in Care Management for Senior Populations

Care Management is a service designed to help patients and their caregivers manage medical conditions more effectively, in order to improve health and reduce the need for hospitalizations and emergency department visits. The concept arose in the past decade from disease management programs of the 1990s, which focused on individual diseases rather than more comprehensive consideration of patients’ needs. Care …

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