Evaluation Domains and Activities

Evaluation Domains & Activities

IHPI’s evaluation of the Healthy Michigan Plan is examining the following seven domains, as outlined in the Special Terms and Conditions approved by the federal Centers for Medicare and Medicaid Services (CMS):        
  1. The extent to which the increased availability of health insurance reduces the costs of uncompensated care borne by hospitals;
  2. The extent to which availability of affordable health insurance results in a reduction in the number of uninsured individuals who reside in Michigan;
  3. Whether the availability of affordable health insurance, including coverage for preventive and health and wellness activities, will increase healthy behaviors and improve health outcomes;
  4. The extent to which enrollees believe that the Healthy Michigan Plan has a positive impact on personal health outcomes;
  5. Whether requiring enrollees to make contributions toward the cost of their health care results in dropped coverage, and whether collecting an average co-pay from enrollees in lieu of copayments at the point of service affects enrollees’ propensity to use services; and
  6. Whether providing a MI Health Account into which enrollees’ contributions are deposited, that provides quarterly statements detailing utilization and contributions, and allows for reductions in future contribution requirements, deters enrollees from receiving needed health services or encourages enrollees to be more cost-conscious.
  7. Whether the Marketplace Option demonstrates cost effectiveness taking into account both initial and longer-term costs and other impacts as compared to the Healthy Michigan Plan.

CMS Required Evaluation Activities to Date

Primary Care Practitioner (PCP) Survey

Developed and conducted a survey of Michigan PCPs with at least 12 assigned HMP patients to describe PCPs’ experiences caring for HMP enrollees, practice approaches and innovations adopted or planned in response to HMP, and future plans regarding care of HMP patients. Survey was fielded in 2015; there were 2,104 respondents with a response rate of 56%.

Healthy Michigan Voices (HMV) Survey

Developed and conducted a telephone survey of more than 4,000 people enrolled in HMP and 1,000 people who have disenrolled in 2016. These surveys are being repeated in 2017 and 2018 to allow for a longitudinal analysis of perspectives of HMP enrollees. Interviews with those who are eligible but remain unenrolled will also be conducted in 2017 and 2018. A modified version of the Healthy Michigan Voices survey will be fielded in 2019.

Other Healthy Michigan Plan Evaluation Activities to Date

Annual Report on Uncompensated Care and Insurance Premium Rates

Developed a yearly report on uncompensated care and insurance premium rates for the legislature in December of each year, beginning in 2014. This report utilizes MDHHS cost report data to examine uncompensated care at Michigan hospitals and rate filings and interviews to examine factors influencing insurance premium rates and rate setting.

Experiences of Enrollees and Providers with HMP

Conducted more than 100 semi-structured telephone interviews, including 67 with HMP enrollees, 19 with PCPs and 28 with other providers serving HMP enrollees to inform survey items and measures and to enhance the interpretation of survey findings.

Early Experiences with MI Health Account Statements Project

Conducted 32 in-person cognitive interviews with HMP enrollees in 2015 after their receipt of at least one MI Health Account statement which includes information on health care spending and payment responsibilities. The report provides an early look at enrollee understanding of the statement and its purpose, perceptions of cost sharing, how behaviors are influenced by the statement, and payment experiences.