Front-line medical providers say Michigan's Medicaid expansion helped patients' health and ability to work

Extending medical insurance to low-income Michigan residents meant they had better access to health care, earlier detection of serious illnesses, better care for existing health problems, and improved ability to work, attend school and live independently, according to a newly published survey of primary care providers.

Published in the  Journal of General Internal Medicine by lead author Susan Goold, M.D., M.H.S.A., M.A., professor of internal medicine, the results come from 2,104 primary care doctors, nurse practitioners and physician assistants who care for 12 or more people insured by the Healthy Michigan Plan, Michigan's expansion of the Medicaid insurance program to low-income adults.

Making big data work for better heart health

Heart failure and atrial fibrillation (AF) are two common chronic conditions that can be managed if recognized early, but can have deadly consequences if they go undetected.

What if the most useful information about heart function could be seized from the largely untapped volumes of data already generated through a range of healthcare encounters, mobile devices, and what patients themselves report, and synthesized together to provide vastly improved new diagnostic tools?

Two U-M projects, supported by NIH career development awards, will use data science and analytic methods to attempt just that, with the goal of improving the ability to detect these conditions earlier, more reliably, and less expensively.  Learn more about the research aims of Michael Mathis, M.D., U-M assistant professor of anesthesiology and  Hamid Ghanbari, M.D., M.P.H., U-M assistant professor of cardiovascular medicine.
Most hospitals now require workers to get flu shots---- except those that treat veterans, study finds

In just a few short months, hospitals across the country will start their annual push to make sure their workers get vaccinated against influenza, to protect themselves and others. Memories of the last flu season ---- one of the worst in years ---- still linger.

A new study by a team from U-M and VA Ann Arbor Healthcare Systems shows a rapid rise in the percentage of hospitals that require the vaccine ---- except among those that focus on treating the nation's military veterans.

In two surveys taken four years apart, the percentage of Veterans Affairs hospitals that have a flu vaccine mandate rose only slightly, from 1 percent in 2013 to 4 percent in 2017, the study shows. But at the same time, the percentage of non-VA hospitals requiring flu shots rose from 44 percent to nearly 70 percent.

Risks, outcomes differ depending on breast reconstructive surgery type

For many women facing treatment for breast cancer, breast reconstruction after mastectomy is a quality of life issue. It is linked with feeling more feminine, or "whole again" after surgery. But choosing the type of reconstruction is a complex process, and the decision can be difficult and stressful.

A new study from a multicenter research consortium sponsored by Michigan Medicine aims to help breast cancer patients make these decisions while armed with important data about the risks and rewards associated with each surgical option. The study was published in JAMA Surgery by lead author  Edward Wilkins, M.D., M.S., U-M professor of plastic surgery.

National Poll on Healthy Aging: Perspectives on relationships and sex

Romantic relationships are important to well-being and quality of life at any age. While sex is an integral part of the lives of many older adults, this topic remains understudied and infrequently discussed.

The University of Michigan National Poll on Healthy Aging asked a national sample of adults age 65 --- 80 about their perspectives on relationships and sex and their experiences related to sexual health.

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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.
Points of Impact: Amy Kilbourne, Ph.D., M.P.H.

Every day, health services researchers discover better ways of organizing and delivering care with the potential to significantly improve costs and outcomes. But how ---- and how often ---- are their discoveries fully implemented in the real world, which can present a variety of barriers to adopting novel ideas?

Over her career, Amy Kilbourne, Ph.D., M.P.H., a U-M professor of psychiatry, has developed nationally recognized expertise in a growing field known as implementation science, which studies the most effective methods or strategies to help healthcare providers adapt and adopt best practices, and, even more importantly, how they can sustain them. Here, she discusses how implementation scientists partner with providers and other researchers to integrate new evidence throughout routine healthcare practice and more rapidly respond to current health policy challenges.

The health and economic effects of Michigan Medicaid expansion

Sarah Miller, Ph.D., assistant professor of business, Renuka Tipirneni, M.D., M.Sc., assistant professor of internal medicine, and IHPI Director John Ayanian, M.D., M.P.P., were the guest speakers at U-M Medical School's Frontier Seminar Series. Their presentation included a background on Medicaid expansion in Michigan, an overview of findings regarding Medicaid work requirements, and the financial impacts of expansion in Michigan.

Fendrick discusses the patient experience with The Atlantic

Mark Fendrick, M.D., professor of internal medicine and director of the Center for Value-Based Insurance Design, was a special guest panelist for "The State of Care: Patient Access & Affordability" hosted by The Atlantic. The panel presented key perspectives to continue the conversation on what it costs to stay healthy in America today. You can view Dr. Fendrick's segment at 34 minutes into the video below.


Michigan Center for Hand Outcomes and Innovation Research

The Michigan Center for Hand Outcomes and Innovation Research (M-CHOIR) is the research arm of the University of Michigan Comprehensive Hand and Upper Extremity Center. Founded in 1998, M-CHOIR performs a wide array of clinical and health services research. Primary methodologies include decision analyses, large database studies, and clinical trials. M-CHOIR aims to provide insight for various plastic surgery global outreach efforts.

Discover more U-M health services milestones through our interactive timeline.
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:
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IHPI Informs is published monthly by the University of Michigan Institute for Healthcare Policy & Innovation.
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