In a time of transformation, what’s working (and what’s not)?

Our nation’s healthcare system continues to undergo big changes in the way health services are organized, delivered, and paid for. IHPI members study healthcare reforms from many perspectives, to determine how these policies and programs may affect the health and financial well-being of individuals, families, communities, and organizations.

At a time when the stakes have never been higher, IHPI is helping fulfill the growing need for evidence to bring greater clarity to decision-making in this sphere. Reforms related to policy around Medicaid, the public health insurance program for low-income individuals, are one example.

Medicaid in Michigan

Since the Medicaid program in Michigan broadened eligibility in 2014 to include adults with incomes up to 133% of the Federal Poverty Level, the Healthy Michigan Plan has provided coverage to some 1 million Michigan residents.

Over the last five years, an IHPI team has been evaluating the expansion for the Michigan Department of Health and Human Services (MDHHS), while other IHPI researchers are studying the program’s impact in other ways.

So what have they learned?

The number of uninsured adults in Michigan has decreased substantially.

Most enrollees have regular primary care visits and receive preventive care, while their reliance on emergency departments as a usual source of care has decreased.

HMP enrollees report improved physical, mental, and oral health, and better access to primary care and preventive services (particularly for those with chronic health conditions, nearly half of whom were diagnosed after enrolling in the program). Access to some services such as specialty care remains challenging.

Enrollees generally say their financial well-being, ability to work, and ability to look for work (if unemployed) has improved under the coverage.

Michigan hospitals have seen sizable reductions in uncompensated care.

Throughout the HMP evaluation, the team’s findings have guided MDHHS and the CMS on improving the Medicaid program. Findings from the evaluation and other IHPI studies are informing critical policy decisions in Michigan and other states throughout the nation considering making changes to their own Medicaid programs. The evaluation team has also conducted influential research on the broader economic effects of Medicaid expansion and ways to mitigate potential harms of Medicaid work requirements.

Through formal reports to the state, high-profile peer-reviewed journal articles, local and national news media, and briefings for state legislators and health department leaders around the country, the team has disseminated results from this rigorous evaluation – informing policymakers who shape key policy decisions that affect the healthcare and health of millions of Americans.

Nationally, IHPI member research has examined the impact of reforms instituted through the Affordable Care Act and related policies since its implementation in 2010, evaluating incentive systems and practices, insurance coverage and benefits, individuals’ financial health, Medicaid expansion in other states, access to specialty care, and many other angles.

What if you could become an architect to reform our healthcare system?

The “Understanding and Improving the U.S. Healthcare System” residential online course provides U-M students from a wide variety of backgrounds with an engaging, practical, and interactive way to learn about the fundamentals of the U.S. healthcare system and gain insight into how they can improve it.

Discover U-M experts who study healthcare reform and Medicaid policy.

Find the latest news from IHPI on healthcare reform and Medicaid policy.

Top Policy & Practice Insights: 2019