Publications

Publications

The feet and legs of many people sitting in chair in the waiting room of a primary care physician.
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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Test tubes, most filled with pills and one filled with money, indicating the rising cost of specialty drugs.

Rising cost of specialty drugs in Michigan and the United States: A case example for Multiple Sclerosis

Specialty drugs continue to be a growing component of the prescription drug market and the increase in their cost has fueled increases in overall prescription drug spending. These drugs are used to treat complex and chronic medical conditions such as cancer, hepatitis C, multiple sclerosis (MS), and rheumatoid arthritis. They typically require special handling, administration, and monitoring, adding to their …

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Buttons decorated like the American flag, with

Health Care Provisions in the Tax Cuts and Jobs Act (H.R. 1)

The Tax Cuts and Jobs Act passed the U.S. House of Representatives on November 16, 2017, and an amended version passed the U.S. Senate on December 2, 2017. Congress reconciled the differences between the two bills in a compromise conference report. While the purpose of the legislation is to reduce tax rates for businesses and individuals, it includes several major …

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health

Health Insurance Marketplace in Michigan 2018: Rate Analysis

In 2017, the federal government took several regulatory and administrative actions that affect the health insurance marketplaces created under the Affordable Care Act (ACA). At the same time that Congress considered legislative proposals to repeal and replace the ACA, the U.S. Department of Health and Human Services (HHS) promulgated new regulations that changed annual open enrollment dates and announced the …

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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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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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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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Comparing Key Provisions: Affordable Care Act, American Health Care Act, and the Graham-Cassidy Proposal

In July 2017, the United States Senate rejected a series of proposals to repeal and replace the Affordable Care Act (ACA). On September 13, 2017, Senators Lindsey Graham and Bill Cassidy introduced a new proposal to repeal and replace the ACA. The Graham-Cassidy proposal retains some similarities to the American Health Care Act, which passed the U.S. House of Representatives …

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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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