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Reports show the way Americans receive and pay for health insurance has been changing for more than 10 years

The Center for Healthcare Research & Transformation (CHRT) today released two briefs showing that for more than a decade, employers have been dropping health insurance and consumers have been paying more out-of-pocket for health care, a trend that began many years before the development of the Affordable Care Act. The research briefs also show Michigan’s employers are increasing employee cost-sharing and moving to high deductible health plans at a faster rate than the national average.

According to the data, from 1999 to 2011, the proportion of individuals covered by employer-sponsored insurance decreased by approximately 15 percent nationwide. Between 2008 and 2011 specifically, the proportion of people with private health insurance (either through their employers or individually-purchased) fell 4.7 percent in Michigan and 4.4 percent nationwide.Continue Reading Reports show the way Americans receive and pay for health insurance has been changing for more than 10 years

A call for child passenger safety

Dr. Michelle Macy, a 2013 CHRT Policy Fellow, wrote an opinion piece in the Detroit News which argues that Michigan’s Child Passenger Safety Law has not kept pace with recent research and recommendations from the American Academy of Pediatrics. Dr. Macy states that we should require rear-facing car seat use beyond 1 year —and booster seat use until the until the vehicle seat belt fits properly, which is usually is when a child is, on average, 11 years old. She urges the legislature to consider updating the law, noting that child safety should be a bi-partisan issue.

Understanding the Affordable Health Care Act

Amy Lange with Fox 2 News sits down with CHRT Director Marianne Udow-Phillips to find out what consumers need to know about the Affordable Care Act before the new health insurance exchanges launch Oct. 1.

A lesson from Massachusetts: Biz, government should work together

Among the coverage in a Crain’s Detroit Business special section aimed at educating employers and employees on the coming changes under the ACA is a retelling of a previous article summarizing CHRT’s Massachusetts Comes to Michigan: Lessons about Health Care Reform from Business Leaders symposium in February 2013.

Recession, increase in uncompensated care severely strain Michigan’s health care safety net, says Center for Healthcare Research & Transformation

A report released today by the Center for Healthcare Research & Transformation (CHRT) outlines the severe impact of Michigan’s recession on the ability of the health care safety net to provide health care to the growing number of Michigan residents who need their services.

From 2007 to 2011, uncompensated care provided by Michigan hospitals increased 42 percent, and patient volume at federally qualified health centers (FQHCs) increased by 22 percent. The number of uninsured increased by 133,000, yet there was no net increase in the number of free clinics statewide. In fact, five of seven free clinics in the Upper Peninsula closed, leaving just two clinics for the entire population.

“These trends emphasize how important the Medicaid expansion in Michigan is in terms of access to care,” says Marianne Udow-Phillips, director of CHRT. “The demand for low and no cost care through federally qualified health centers has increased in Michigan. At the same time, some free clinics in the state have closed anticipating that Medicaid will expand. If the expansion does not occur, there will be further pressure on the FQHCs in the state to provide access or more care will likely be delivered at the nearest emergency room, further escalating the rate of uncompensated care that hospitals provide.”

The strain on the health care safety net results in cost shifting to private insurers, higher premiums, and a continuation of the cost/access challenges evident in Michigan and nationwide, says Udow-Phillips.

CHRT’s review of Michigan’s health care safety net includes additional findings, such as:

  • The Medicaid coverage rate increased steadily from 12.2 percent of the population in 2007, to 17.5 percent in 2011.
  • The number of patient visits for medical, dental, substance use and mental health care at FQHCs increased from 1.6 million in 2007 to nearly 2 million in 2011.
  • At FQHCs, mental health visits increased by 128 percent, far surpassing the increased visits for dental care (36 percent), medical care (21 percent) and substance use services (11 percent).
  • While the total number of free clinics remained at 75 across the state, the geographic distribution changed greatly. Southeast and Southwest Michigan saw increases in the number of free clinics, yet the Upper Peninsula lost seven of nine clinics.

The report also points to the gradual reduction of disproportionate share hospital (DSH) payments as a challenge for hospitals. These federal funds help compensate hospitals that care for a higher proportion of uninsured patients. Beginning in fiscal year 2014, these payments will be reduced and will eventually cease.

This publication is the fourth in the Cover Michigan 2013 series. Future publications will cover other aspects of health care in Michigan.