Over the past 9 years, the Center for Healthcare Research & Transformation (CHRT) has informed policy decisions that have impacted the health care landscape in Michigan and beyond. CHRT transforms research into policy. In this context, CHRT has directly contributed to a body of health services research and analyses for policy makers, run demonstration projects to show how health and health care can be improved and helped researchers become more effective at creating and disseminating research. CHRT focuses on enhancing evidence-based health care delivery, the health of the population, and access to care. Examples of CHRT’s impact include the following:
Research and Analytic Impact
- Surveyed Michigan consumers over the past 7 years on their insurance coverage status and access to care, providing important pre-ACA implementation data that allows for continued tracking of these trends over time. Starting in 2012, began surveying primary care physicians in Michigan on practice capacity, ability to take new patients and changing practice patterns, which influenced the State of Michigan’s decision to expand Medicaid:
- Published 89 issue briefs, on a range of topics, including translating the technical details of the ACA and implementation impacts for a policy maker audience; the cost and use of health care services in Michigan and nationally; and, innovations to improve health care delivery and financing. Issue briefs have been viewed online more than 150,000 times, and CHRT has become a trusted go-to source for timely explanation and contextualization of the ACA’s impact on key market sectors in Michigan and beyond for policy makers and the media.
- Sponsored 5 major symposia focusing on health reform and health reform impacts including top national media and researchers such as Stephen Brill, Julie Rovner, Jonathan Cohn, Sarah Rosenbaum
- Produced seminal geographic and physician organization variation analyses, building on the 2000 Dartmouth Atlas of Health Care Services in Michigan and appropriateness of care analyses to aid design and implementation of payer-led pay for performance initiatives;
- Advised one of the nation’s largest health care purchasers through clinically informed claims data analysis on ways to improve benefit designs to enhance cost effectiveness and quality of care; and
- Funded 26 health services research studies that focused on informing health policy or practice questions related to evidence based care delivery and insurance product design. For example, CHRT-funded studies examined issues such as low back pain treatment, Patient Centered Medical Homes, Value-Based Insurance Design, and the use of pediatric observation beds in the emergency department.
- Informed Michigan’s decision to expand Medicaid through key fiscal analyses that projected over $1 billion in net savings to the state over 10 years and through survey data that showed ready access for beneficiaries to primary care providers in the state;
- Trained over 50 senior clinician and health policy researchers and legislative staffers through the CHRT Policy Fellowship program. Many former fellows now serve in key legislative positions in Michigan and Washington, D.C. and influence health legislation at the state and federal levels.
- Joined with the Rockefeller Institute of Government, the Brookings Institution, and the Fels Institute of Government at the University of Pennsylvania to analyze state-level ACA impacts and become a regional hub for ongoing tracking.
- Wrote Michigan’s successful Multi-Payer Advanced Primary Care Practice grant. Partnered with the State of Michigan and the University of Michigan Health System to implement the grant with a focus on improving primary care for those with chronic disease. Largest patient centered medical home initiative in the country including Medicare, Medicaid and commercial carriers; over 400 primary care practices; of the 8 states in the demonstration program, one of only 2 to show consistent savings over the 3 years of the demonstration period, net Medicare savings of $336 million. Provided $110 million in additional Medicare payments to providers in Michigan over the demonstration period. Now transitioning to an ongoing initiative.
- Facilitated a major community health collaborative, including more than 200 individuals representing over 80 organizations, with a focus on integrating and delivering better care to the low income, Medicaid and uninsured populations. Sponsored by the University of Michigan Health System and Saint Joseph Mercy Health System; funders also include United Way, Ann Arbor Area Community Foundation, Ann Arbor City, and Washtenaw County. Of note, the collaborative effort has directly helped save over 23 lives from opioid overdoses, and helped 700 people retain or enroll in health coverage or obtain access to other critical social support services.
- Selected as the regional backbone for the State Innovation Model (SIM) grant by the Michigan Department of Health and Human Services. Major 4 year, $70 million grant to the State of Michigan. 5 core regions are participating. SIM’s focus on ways to better coordinate care and lower costs through connecting the medical care delivery systems (Accountable Care Organizations; Patient Centered Medical Homes) to the human services system (e.g. housing, mental health, transportation).