IHPI’s goals and priorities and its future as an institute are founded upon the substantial accomplishments in health services research and health policy that have distinguished the University of Michigan’s history over the last two centuries. Discover more in this timeline of significant milestones compiled from across the university and IHPI’s local partners.
The origins of the University of Michigan
The University of Michigan is founded in Detroit in 1817. In 1837, the Board of Regents held its first meeting in Ann Arbor and formally accepted the proposal by the town to locate the university there. The first college-level classes were held at U-M in Ann Arbor in 1841.
Beginnings of the U-M School of Dentistry
The U-M School of Dentistry is founded as the College of Dental Surgery, making U-M the first state university in the world and the second university in the U.S. to offer education in dentistry. The college was renamed the School of Dentistry in 1927.
Public Health moves to new graduate division
The Board of Regents highlights the interdisciplinary nature of public health by moving programs from the Medical School to a new Graduate School Division of Hygiene.
“The Social and Economic Aspects of Public Health and Medicine”
“The Social and Economic Aspects of Public Health and Medicine,” believed to be first course on medical care organization and financing offered at a U.S. university, is taught at U-M.
Sinai helps develop voluntary health insurance plan
U-M’s Nathan Sinai, a professor of Hygiene and Public Health, develops a voluntary health insurance plan with the Michigan State Medical Society that later becomes a prototype for Blue Shield.
“Public Health Economics and Medical Care Abstracts” published
Public Health Economics and Medical Care Abstracts [which eventually became Medical Care Review (1967) and subsequently Medical Care Research and Review (1995)] is published by the U-M Bureau of Public Health Economics in the School of Public Health [see next].
Regents approve Bureau of Public Health Economics
The Board of Regents approves the Bureau of Public Health Economics within the School of Public Health. Its Medical Care Reference Collection becomes the nation’s primary source of archival information on community aspects of medical care.
Institute for Social Research established at U-M
The Institute for Social Research (ISR), among the world’s largest and oldest academic survey research organizations, and a leader in the development and application of social science methods and education, is established at U-M. ISR’s portfolio of work includes a breadth of research examining the relationships between human health, behavior, and social factors. Rensis Likert, an organizational psychologist and developer of the Likert Scale, served as ISR’s first director (pictured at left with Angus Campbell, ISR’s co-founder and second director).
Thomas Francis Jr. concludes field trials of Salk polio vaccine
SPH Professor Thomas Francis Jr. concludes the two-year national field trials of the Salk polio vaccine, and on April 12 announces to the world that the vaccine developed by his former student Jonas Salk is “safe, effective, and potent.”
Tecumseh Community Health Study launches
The Tecumseh Community Health Study begins through the efforts of SPH and other U-M faculty, focusing on behavioral, environmental, and family factors associated with cardiovascular disease and other chronic conditions. The study focused on the entire community of Tecumseh, Michigan, rather than a representative sample. The investigators were able to quantify the role of a number of factors involved in the development of coronary heart disease.
The Formative Years
The 1960s saw the beginnings of significant changes in the American healthcare system. The period was marked by the rapid expansion of social programs, including the establishment of Medicare and Medicaid in 1965, and the concomitant blossoming of social sciences and federal support for this research. HSR came into greater prominence as a field over the next 50 years, helped by various shifts in healthcare financing that incentivized interdisciplinary research on how healthcare was organized, delivered, and paid for.
Axelrod expands SPH program in Medical Care Organization
SPH Professor S.J. “Sy” Axelrod expands the SPH program in Medical Care Organization, which soon takes on a central role in educating administrators for the Social Security Administration, established by Congress in 1965.
CRUSK begins at ISR
The Center for Research on the Utilization of Scientific Knowledge (CRUSK) is established at ISR; undertakes a variety of HSR and other research until 1985, when its work was largely absorbed into ISR’s three other research centers.
Donabedian publishes “Evaluating the Quality of Medical Care”
Avedis Donabedian’s landmark article “Evaluating the Quality of Medical Care” is published in the Milbank Quarterly, establishing the widely used structure-process-outcome framework. The papers were commissioned by NIH’s Health Services Research Study Section from carefully selected authors as a means of defining the scope, methods, and standards of the field.
Mott Hospital opens its doors. Mott was the U-M’s first separate children’s hospital and is now among the nation’s leading pediatric health care centers.
Future Directions in Health Services Research Conference
U-M hosts conference on “Future Directions in Health Services Research,” organized by the newly formed Health Services Research Group, a cross-campus organization of health services researchers.
U-M establishes Health Services Research Center
U-M establishes the Health Services Research Center, located within the Office of the Vice President for Research, after receiving one of five original awards from the National Center for Health Services Research (a predecessor of the Agency for Healthcare Research & Quality). U-M’s center continued through 1979.
Establishment of U-M Center for Nursing Research
The U-M Center for Nursing Research is established and nursing research becomes central to the mission of the School of Nursing.
Health Services Research Comes of Age
Interdisciplinary collaborations flourish in health services research, as investigators organize themselves and develop new partnerships around pressing questions related to healthcare quality, costs, access, and equity. Beginning in the 1990s, U-M’s own health system developed and implemented innovative health programs with high intensity medical and disease management (first used in pilot insurance products with Ford and General Motors—Partnership Health and ActiveCare), and many of these are still used in UMHS initiatives.
U-M creates M-CARE
In response to the need to contain medical costs, U-M establishes M-CARE, becoming the second university in the U.S. to create its own managed care program. M-CARE also reviewed, facilitated, and supported clinical and health services research activities and provided a rich source of healthcare data for analysis. It was acquired by Blue Cross Blue Shield of Michigan in 2006.
Warner’s work in tobacco and health
SPH Professor Kenneth Warner serves as senior scientific editor of the 25th anniversary Surgeon General’s report on smoking and health. His Congressional testimony in 1985 helped solidify federal taxation as a smoking disincentive.
The Serious Mental Illness Treatment Resource and Evaluation Center (SMITREC) is established at the Ann Arbor VA in partnership with the Department of Psychiatry. SMITREC is now co-located with CCMR.
Clinical Scholars Program launched
Arbor Research Collaborative for Health is founded
Arbor Research Collaborative for Health, a future IHPI local partner, was founded by U-M researchers as the University Renal Research and Education Association (URREA); it was renamed in 2006 to better reflect the breadth of its efforts to improve patient care and support the development of sound public healthcare policies.
Establishment of the Panel Study of Income Dynamics and Child Development Supplement.
As the largest and longest-ever longitudinal, genealogically based study of the US population, the PSID (housed at ISR and initiated in 1968) is one of the original population-level assessments of health in the contexts of social determinants. The addition of the Child Development Supplement substantially expanded the health-focused measures of the PSID effort and set the stage for biomarker-focused research combined with intensive survey data collection that has now become its hallmark.
Origins of the U-M Injury Prevention Center
The U-M Injury Prevention Center had its origins as the Injury Research Center (founded within the Department of Emergency Medicine by Ron Maio), which in 2010 merged with the Center for Injury Prevention among Youth (founded by Jean Shope in 2008). The Injury Prevention Center was designated a CDC-funded Injury Control Research Center in 2012.
Launch of first Collaborative Quality Initiative
A group of five hospitals in Michigan – led by U-M cardiologists and supported by the Blue Cross Blue Shield of Michigan Foundation and Blue Care Network – launches the Blue Cross Blue Shield Cardiovascular Consortium-Percutaneous Coronary Intervention (BMC2-PCI), an initiative to study variation in angioplasty. This first Collaborative Quality Initiative (CQI) paved the way for more than 20 other BCBSM initiatives, most of them led by U-M medical faculty, to collect, analyze, and share data to improve healthcare processes and outcomes across some of the most common and costly areas of healthcare in Michigan.
The Child Health Evaluation and Research (CHEAR) Unit is established by Gary L. Freed, M.D., M.P.H. In 1998, Dr. Freed was recruited from UNC—Chapel Hill to lead the Division of General Pediatrics at U-M. Upon his arrival, he founded the CHEAR Unit, designed as a multidisciplinary, cross-campus research initiative focusing on child and family health, healthcare utilization, and health policy.
The CHEAR Unit is the largest and most successful pediatric health services research unit in the US. Working with his longtime collaborator, Sarah J. Clark, M.P.H., Dr. Freed rapidly established the CHEAR Unit as a rigorous source of program and policy evaluation for major initiatives implemented by agencies such as the CDC and the Michigan Medicaid program. Dr. Freed also actively recruited several junior faculty from other institutions who went on to become leaders in the field of pediatric health services research, and in 2000 he obtained funding from NICHD for the first pediatric health services research training program (T32) supported by NIH that drew other talented pediatricians to CHEAR for fellowship and subsequent faculty positions at UM and other leading academic institutions. Under Dr. Freed’s leadership, the CHEAR Unit grew to become a pre-eminent pediatric health services research group in the United States.
Master’s of Science in Health and Health Care Research program established
The Master’s of Science in Health and Health Care Research program is established through Rackham Graduate School, originally designed for scholars who were admitted to the Robert Wood Johnson Foundation Clinical Scholars Program at U-M (now the IHPI Clinician Scholars Program). Today, IHPI administers the Master’s program.
Healthy Minds Study launches
The Healthy Minds Study (HMS), an annual survey examining mental health service utilization and related issues among undergraduate and graduate students, launches. HMS, based in the School of Public Health with significant involvement from the Institute for Social Research and the U-M Depression Center, has been fielded at more than 125 college and university campuses across the U.S. and internationally, with over 150,000 survey respondents.
V-BID principles incorporated into ACA
Incorporating research from the U-M Center for Value-Based Insurance Design (V-BID), comprehensive healthcare reform is enacted through the Affordable Care Act, including provisions to authorize health plans nationwide to remove barriers for high-value preventive medical services.
CHOP begins at U-M
The Center for Health Outcomes & Policy (CHOP), a consortium of more than 100 faculty and staff, including clinician scientists, economists, biostatisticians, epidemiologists and other social scientists from the Medical School and School of Public Health, is established at U-M.
The Center for Bioethics and Social Sciences in Medicine (CBSSM), supported by the Dean’s Office at the Medical School, the Department of Internal Medicine, the Department of Psychiatry, and the Ann Arbor Veterans Administration Medical Center (Center for Clinical Management Research), is established at U-M.
Looking Toward the Future
The early 21st century has seen previously unprecedented challenges and opportunities for the U.S. healthcare system. Recognizing the tremendous potential for providing a common home for the many rich veins of ongoing research, programs, and partnerships at U-M at a most critical time for healthcare in the U.S., the U-M Regents approved the creation of the Institute for Healthcare Policy & Innovation (IHPI) in 2011. This milestone paralleled the proliferation of large healthcare data sets, a continued focus on healthcare accessibility, safety, affordability, effectiveness, cost-transparency, patient-centered care, and an ever-growing demand for translating health services research to inform public policy.
Dialysis payment reforms implemented
The U.S. Centers for Medicare & Medicaid Services implement a new dialysis payment system developed by the U-M Kidney Epidemiology and Cost Center (KECC), which leads to a reduction of approximately $225 million per year in Medicare payments for dialysis.
The Center for Clinical Outcomes Development and Application (CODA), whose mission is to achieve excellence in measurement development, selection, and application to improve clinical health research and care, is established at U-M.
Path of Excellence in Health Policy and Economics launched
The Medical School begins offering medical students the choice to pursue a Path of Excellence in Health Policy and Health Economics, in collaboration with IHPI.
Responding to COVID-19
IHPI researchers and clinicians have played a critical role in responding to the COVID-19 pandemic, building models to project virus spread and its impact on populations, developing clinical resources and guidelines for the frontlines of care, and creating data registries to better understand treatment outcomes.
The need for innovation and critical evaluation within healthcare and health policy is at one of its greatest in history. IHPI focuses its vision firmly on the future, with its goals and priorities founded on the vibrant work in health services research that has preceded the institute and continues to thrive with new energy and direction.