What does expanded Medicaid mean for the health and work lives of enrollees?

Five states will expand Medicaid in 2019. Fourteen may start requiring Medicaid enrollees to work in return for their health coverage. And a new study could help all of these states understand what might be in store under these policies.

Conducted by the University of Michigan Institute for Healthcare Policy and Innovation, the study finds that nearly half of people covered by Michigan's expanded Medicaid program felt their physical health improved in the first year or two after they enrolled in the program. More than a third said their mental or dental health had improved.

These self-reported improvements in health occurred earlier than had been seen in studies in other states. The study, led by Renuka Tipirneni, M.D., M.Sc., U-M assistant professor of internal medicine, was published in the Journal of General Internal Medicine.

IHPI researchers offer potential solutions for scaling-up increasingly popular remote healthcare services

For many patients, a doctor's visit can mean weeks long waits for an appointment, transportation issues, and other inconveniences ---- even for brief encounters that don't require a physical exam.

Increasingly, major health systems throughout the country are implementing telehealth programs in an effort to increase access and improve patient experiences. This move is made possible by more support from insurance payers, including the Centers for Medicare and Medicaid Services, which recently announced a proposal to expand telehealth access for Medicare recipients. Michigan Medicine's Chad Ellimoottil, M.D., M.S., U-M assistant professor of urology, and a team of experts describe some of the most common issues that large health systems encounter when implementing telehealth programs and approaches to overcoming them.

How children and teens die in America: Study reveals the widespread and persistent role of firearms

America lost 20,360 children and teens in 2016 ---- 60 percent of them to preventable injuries, a new study shows. More than 4,000 of them died in motor vehicle crashes, though prevention efforts and better trauma care have cut the death rate of young people from such crashes in half in less than two decades.

Meanwhile, firearms ---- the number two cause of death in youth ---- claimed the lives of more than 3,140 children and teens in 2016, according to the new findings by members of the U-M Injury Prevention Center and led by Rebecca Cunningham, M.D., U-M professor of emergency medicine.

The study, published in the New England Journal of Medicine, was done using publicly available data from the U.S. Centers for Disease Control and Prevention's WONDER database of information from death certificates.


Study: Rise in meth and opioid use during pregnancy

Amphetamine and opioid use in pregnancy increased substantially over the last decade in the United States, a new study by U-M assistant professor of obstetrics and gynecology Lindsay Admon, M.D., M.Sc., finds. And a disproportionate rise occurred in rural counties.

Among pregnant women in all parts of the country, amphetamine-affected births (mostly attributed to methamphetamine) doubled from 1.2 per 1,000 hospitalizations in 2008 --- 2009 to 2.4 per 1,000 hospitalizations by 2014 --- 2015, the new research finds. The study appeared in the American Journal of Public Health.


ACA court ruling: Voices of IHPI experts

When news broke last week of a federal court ruling in Texas declaring the Affordable Care Act unconstitutional, several faculty across IHPI lent their expertise to the cause of explaining what it meant --- and didn't mean --- in this piece aimed at Michigan Medicine patients and the general public. One of these experts, Nick Bagley, J.D., professor at the
U-M Law School, also wrote recent commentaries on the court ruling in the Washington Post and the Atlantic.
Cost and weight-loss potential matter most to bariatric surgery patients

A new study published in JAMA Surgery with senior author  Lisa Prosser, M.S., Ph.D., examines what qualities patients look for when choosing a bariatric surgery procedure. And the results were surprising: The most commonly performed bariatric surgery, sleeve gastrectomy, doesn't fit the top qualities that surveyed patients want out of their weight loss journey.

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The Institute brings great minds together to address healthcare's biggest challenges. More than 500 investigators come to IHPI from U-M's top-ranked schools of medicine, nursing, public health, engineering, social work, law, business, and public policy, among others, as well as members of affiliated local research organizations.

Diane Harper: HPV, cervical cancer screening, and balancing benefits and harms

Diane M. Harper, M.D., M.P.H., M.S., professor of family medicine, is internationally recognized for her work in the prevention, diagnosis, and treatment of human papillomavirus (HPV)-associated diseases, which include many types of cancer. Her health services research and policy work have focused on guideline development and publication, particularly around cancer screening.

Here she talks about recent changes to cervical cancer screening recommendations, the need to balance the potential benefits of early detection with the potential harms of overdiagnosis and overtreatment, and the importance of continually revisiting preventive recommendations to consider new evidence, attitudes, behaviors, and the ever-changing health policy landscape.


Improving care for children with sickle cell disease

Sickle cell disease is an inherited blood disorder that can cause excruciating pain episodes and significantly increases the risk of stroke, infection, and other serious health issues.

Sarah Reeves, Ph.D., research assistant professor with the U-M Child Health Evaluation and Research (CHEAR) Center, explains why measuring the quality of care provided to children with sickle cell disease is critical for addressing inequities in care and improving health outcomes.

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Markel talks history, breakfast cereal, and the Kelloggs in new interview with PBS NewsHour

Howard Markel, M.D., Ph.D., U-M George E. Wantz Distinguished Professor of the History of Medicine, describes how the Kellogg brothers transformed the American breakfast at a heavy personal cost. William Brangham of PBS NewsHour talks to Markel about his new book, The Kelloggs: The Battling Brothers of Battle Creek.

The Institute for Healthcare Policy and Innovation is committed to improving the quality, safety, equity, and affordability of healthcare services.

To carry out our ambitious mission, our efforts are focused in four areas:
  • Evaluating the impact of healthcare reforms
  • Improving the health of communities
  • Promoting greater value in healthcare
  • Innovating in IT and healthcare delivery

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IHPI Informs is published monthly by the
University of Michigan Institute for Healthcare Policy & Innovation.
U-M Institute for Healthcare Policy & Innovation
North Campus Research Complex (NCRC)
2800 Plymouth Road, Building 16
Ann Arbor, MI 48109

Eileen Kostanecki
IHPI Policy Engagement and
External Relations Director

Christina Camilli-Whisenhunt
IHPI Communications Director

Kara Gavin
IHPI Research & Policy
Media Relations Manager

Patrick Cliff
IHPI Associate Director of Development

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