Policymakers across the public and private sectors depend on responsive, evidence-based solutions to address urgent questions around health and healthcare quality, access, cost, and equity. IHPI launched Policy Sprints in the spring of 2018 to help provide policymakers with timely and rigorous evidence to inform health policy and practice. Policy Sprint teams undertake rapid analyses to address important health policy questions and produce products that inform ongoing decision-making at the local, state, or national level.
COVID-19 Projects - Launched Summer 2020
Scale-up of COVID-19 diagnostic testing: A framework for decision-makers
Diagnostic testing is critical to the COVID-19 public health response and associated economic recovery. Yet, scaling of testing capacity faces operational, governmental, and policy-related barriers, including shortages of testing supplies and a lack of integrated laboratory networks. Anupindi and colleagues will identify bottlenecks within the COVID-19 diagnostic supply chain and current delivery models, then provide operational and policy recommendations for effectively scaling up coronavirus testing to reopen the economy safely.
- Project lead: Ravi Anupindi, Ph.D., M.E., M.S., Technology & Operations, Stephen M. Ross School of Business
- Team: Rajan Dewar, M.B.B.S., Ph.D., Emily Edkins (MBA candidate), Lee Schroeder, M.D., Ph.D.
- Update: In October 2020, the team published an IHPI Brief that examined the supply chain landscape of COVID-19 testing in Michigan, identified key barriers to scale-up, and outlined policy options.
Workforce policies to sustain behavioral telehealth during COVID-19 recovery
COVID-19 has prompted a rise in mental health needs due to stress from the illness itself, social isolation, and economic loss. To address these increasing needs, federal and state policy changes have been enacted to expand access to behavioral health telehealth services. The regulatory and policy changes are set to expire once the COVID-19 disaster is declared over; thus, is it important to understand the effectiveness of these policy changes. Through interviews with Michigan behavioral health providers, Beck and team will examine providers' perspectives on such policy changes, identifying barriers and promising practices and assessing their perceptions of how the policy changes have aided this work.
- Project lead: Angela Beck, Ph.D., M.P.H., Health Behavior and Health Education, School of Public Health
- Update: In January 2021, the team published an IHPI Brief that assessed Michigan behavioral health providers’ experiences with virtual care and outlined policy considerations to sustain and improve access to telebehavioral health.
Views of parents and guardians of school-age children on public school opening during the COVID-19 pandemic
Many parents and guardians are weighing concerns on whether to send their kids back to public schools if they reopen amid the COVID-19 pandemic. A U-M team led by Chua will survey parents and guardians of school-aged children in Michigan, Illinois, and Ohio to better understand the degree to which families are planning to send children back to school and to assess support for risk mitigation strategies, such as masks, staggered arrival times and random COVID-19 testing. The project aims to help state policymakers and school districts identify potential challenges to the implementation of different strategies.
- Project lead: Kao-Ping Chua, M.D., Ph.D., Pediatrics, Medical School
- Team: Melissa DeJonckheere, Ph.D., Sarah Reeves, Ph.D., M.P.H., Alison Tribble, M.D., Lisa Prosser, Ph.D., M.S.
- Update: In June 2020, Chua and team published an IHPI Brief that examined parents’ plans in Illinois, Michigan, and Ohio for in-person school and support for 15 potential measures to reduce the risk of COVID-19 in schools. In November 2020, the team published their findings in Academic Pediatrics.
Variation in primary care telehealth adoption during COVID-19 and the association with acute care utilization for ambulatory care-sensitive conditions
The COVID-19 pandemic prompted many clinics across the U.S. to significantly reduce in-person visits and shift rapidly to telemedicine. To better understand the impact of this shift on health care access, Li, Ellimoottil, and colleagues will assess if variability in primary care providers’ uptake of telehealth is associated with rates of acute care use among their patients. Examining how provider telehealth adoption differed geographically or by provider characteristics during this time can inform future policies to shape more equitable and universal access.
- Project leads: Kathleen Li, M.D., Emergency Medicine, Medical School; Chad Ellimoottil, M.D., M.S., Urology, Medical School
- Team: Keith Kocher, M.D., M.P.H., Jeff Kullgren, M.D., M.P.H., M.S., Michael Thompson, Ph.D., Jeffrey McCullough, Ph.D., Ziwei Zhu, Ph.D.
- Update: In March 2021, the team published an IHPI Brief that analyzed the relationship between virtual care adoption among Michigan primary care practices and emergency department visits or hospitalizations amid the COVID-19 pandemic.
Projects Launched Spring 2019
Using Claims Data to Estimate Mortality Associated with Large-Scale Disaster Among Older Adults
Deaths attributable to disasters are poorly understood and official mortality estimates have traditionally taken only direct causes into account, rather than considering the contributing factors associated with a disaster that led to death. This project analyzes all-cause mortality in older adults after three major U.S. hurricanes, utilizing claims data.
- Project lead: Sue Anne Bell, Ph.D., M.S.N., M.Sc., FNP-BC, Health Behavior and Biological Sciences, School of Nursing
- Team: Xingyu (Mark) Zhang, Ph.D., M.S., Matthew Davis, Ph.D., M.P.H., Theodore (Jack) Iwashyna, M.D., Ph.D., Nicole Lurie, M.D., M.S.P.H. (University of Pennsylvania Distinguished Health Policy Fellow)
- Update: In February 2020, the team published an IHPI brief that examined the health effects of weather- and climate-related disasters on older adults in the U.S. In November 2020, the team published a pair of studies that showed that more older adults are hospitalized in the month following hurricanes while fewer clinicians are available in some of their communities.
Consumer Decision-Making About the Use of Health Savings Accounts
The expansion of health savings accounts (HSAs) has been a centerpiece of recent federal health reform proposals. However, very little is known about consumer behaviors and HSAs. This project will identify which high-deductible health plan enrollees are more likely to have an HSA, what factors are associated with high levels of savings, and why consumers with HSAs may forego opportunities to contribute to their accounts.
- Project lead: Jeffrey Kullgren, M.D., M.S., M.P.H., Internal Medicine, Medical School
- Team: Betsy Cliff, M.S.; Helen Levy, Ph.D., Brady T. West, Ph.D., Angela Fagerlin, Ph.D. (University of Utah School of Medicine), Mark Fendrick, M.D.
Update: In August 2020, the team published an IHPI brief that outlines policy options that could increase the use of HSAs among high-deductible health plan enrollees and help Americans navigate rising health care costs.
TAVR Access and Quality Under New Medicare Coverage Rules
This project will estimate the impact of proposed changes to the Medicare National Coverage Determination for reimbursement of transcatheter aortic valve replacement (TAVR), a minimally invasive therapy for treating aortic stenosis, the most common heart valve disease.
- Project lead: Michael Thompson, Ph.D., Cardiac Surgery, Medical School
- Team: Donald Likosky, Ph.D., Jeffrey McCullough, Ph.D., Francis Pagani, M.D., Ph.D., Devraj Sukul, M.D., Alexander Brescia, M.D.
- Updates: In May 2020, the team published an IHPI brief that outlines policy considerations for expanding access to TAVR and helping to ensure optimal outcomes for patients. In April 2020, the team published a JAMA Cardiology article that analyzed the impact of Medicaid changes on access to TAVR.
Impact of Updated Heart Transplant Allocation Policy on Use of Status-Modifying Therapies
This project will assess potential unintended consequences to recent changes to the heart transplant allocation system that may incentivize physicians to use high-risk, expensive, “status modifying” therapies that increase the likelihood of heart transplant receipt by increasing a patient’s apparent acuity.
Projects Launched Fall 2018
Design and Implementation Challenges of Opioid Prescribing Limits for Acute Pain
Opioid prescribing limits are an important component of the policy response to the US opioid epidemic. This project will highlight design and implementation challenges of these emerging policies to regulate opioid prescribing. The policy sprint will provide insight into how to minimize potential unintended effects and present policy options for addressing these implementation challenges.
- Project lead: Kao-Ping Chua, M.D., Ph.D., Pediatrics, Medical School
- Updates: In May 2020, Chua and team published an IHPI brief that analyzed opioid prescribing limits for acute pain and outlined potential policy considerations to maximize the ability of limits to reduce excessive prescribing. In March 2020, the team published a JAMA Surgery Viewpoint article that examined early evidence on the impact of opioid prescribing limits.
Improving Maternity Outcomes in the U.S.: Using Data and Policy to Promote High-Value Care
Rates of maternal morbidity and mortality are on the rise in the U.S., resulting in an urgent need for new approaches to provide higher value maternity care – that is, care that improves outcomes at a lower cost. This policy sprint will identify key components of successful international prenatal care delivery models to inform state and federal discussions about ways to improve care in the U.S.
- Project lead: Alex Friedman Peahl, M.D., Obstetrics and Gynecology, Medical School
- Team: Vanessa Dalton, M.D., M.P.H., Michele Heisler, M.D., M.P.A., Vineet Chopra, M.D., M.Sc., Michelle Moniz, M.D., M.Sc., FACOG, Lindsay Admon, M.D., M.Sc.
- Updates: In April 2020, the team published a study in the American Journal of Obstetrics & Gynecology (AJOG) on patients' preferences for prenatal and postpartum care delivery. In January 2020, the team published a research letter in AJOG that compares international prenatal care guidelines for low-risk women to inform high-value care.
Short-Term Health Plans and Potential Impact on Women: An IHPI Policy Snapshot
New regulations are increasing access to short-term health plans, which are not required to cover the essential health benefits such as contraceptive and maternity coverage. This policy sprint will explore potential effects of these policies on women’s health, summarizing potential policy options that states may consider undertaking.
- Project lead: Michelle Moniz, M.D., M.Sc., FACOG, Obstetrics and Gynecology, Medical School
- Team: Vanessa Dalton, M.D., M.P.H., Mark Fendrick, M.D.
- Update: In April 2019, the team published an IHPI brief examining state approaches to restrict access to short-term health plans.
Surprise Billing in Surgical Care
Surprise medical bills are endemic to surgical care, arising when a patient chooses an in-network surgeon and facility but receives care from an out-of-network provider – often an assistant surgeon, anesthesiologist, radiologist, or another consultant – during their surgery. This policy sprint will look at the extent to which different types of providers contribute to out-of-network billing in surgical care, informing the national conversation around policies to reduce surprise billing.
- Project leads: Karan Chhabra, M.D., Surgery, Medical School, Kyle Sheetz, M.D., M.S., Surgery, Medical School
- Team: Justin Dimick, M.D., M.P.H.
- Updates: In March 2021, the team published a perspective piece in the New England Journal of Medicine about new federal legislation on out-of-network billing. The U-M Department of Surgery also published an article about the team's work and policy impact. In October 2020, the team published a study in the Annals of Internal Medicine about unexpected bills for screening colonoscopies. They published a study in Health Affairs in April 2020 about the impact of surprise bills in ground and air ambulance transportation. In February 2020, the team published a study in JAMA examining the impact of surprise bills in elective surgery. They also published a Health Affairs blog on surprise billing policy challenges related to the air ambulance industry in October 2019, and a Health Affairs blog post in February 2019 examining various federal policy approaches to ending surprise medical billing.
Projects Launched Spring 2018
Voluntary Alternative Payment Models: Examining the Comprehensive Care for Joint Replacement Model
Alternative payment models (APMs) aim to use financial incentives to improve value in health care. There is debate about whether APMs should be mandatory or voluntary for participating providers. This policy sprint will seek to understand which hospitals dropped out of one APM – the Comprehensive Care for Joint Replacement (CJR) model -- after it transitioned from a mandatory to a voluntary program. Understanding what types of providers dropped out may help inform decisions about the voluntary vs. mandatory nature of future APMs.
- Project leads: Lena Chen, M.D., M.S., Internal Medicine, Medical School, Edward Norton, Ph.D., Health Management & Policy, School of Public Health
- Team: Andrew Ryan, Ph.D., M.A., Jason Gibbons, B.A., Allison Hu, M.H.S.A.
Tobacco 21 in Michigan: New Evidence and Policy Considerations
Across the nation, more than 440 localities and seven states have passed legislation raising their minimum legal tobacco sales age to 21. The Michigan legislature recently introduced a related bill and it is likely to be considered again in the future. This project aims to assess the likely impact of Tobacco 21 policies on the health and well-being of Michigan residents, in addition to assessing potential tax revenue implications.
- Project leads: Holly Jarman, Ph.D., M.Res., Health Management & Policy, School of Public Health, David Mendez, Ph.D., M.S., Health Management & Policy, School of Public Health, Rafael Meza, Ph.D., Epidemiology, School of Public Health.
- Team: Clifford Douglas, J.D., Alex Liber, M.S.P.H., Karalyn Kiessling, M.P.H., Charley Willison, Leia Gu
- Update: The team published a IHPI brief, “Tobacco 21 in Michigan: New Evidence and Policy Options,” in March 2019.