IHPI Policy Sprints

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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.

Health Equity Projects - Launched Spring 2022

Communicated bias and its downstream effects on racial inequities in pain treatment in the emergency department 

Pooja Lagisetty Chris Fung headshots

Numerous studies have demonstrated that Black patients experience disparities in pain treatment during emergency department (ED) visits, including being less likely to receive analgesia or opioids for pain relief compared to their White counterparts. To explore how health provider biases, such as pain-related stigma and racial discrimination, may be driving health inequities, Lagisetty and team will measure potentially stigmatizing language used in triage notes for patients presenting to the ED with pain-related concerns. They will then determine whether differences in triage note language are associated with differences in health outcomes by race/ethnicity.

Racial and ethnic disparities in timely treatment initiation following emergency department visits for non-fatal opioid overdose 

Thuy Nguyen

Despite a substantial rise in U.S. opioid overdose deaths in recent years, buprenorphine, a medication for opioid use disorder (OUD) that substantially decreases fatal overdose risk, remains widely underused, even after emergency department visits for opioid overdose. Moreover, little is known about buprepnorphine treatment among the 38% of low-income adults with OUD covered by Medicaid, a disproportionate share of whom are people of color. To address this knowledge gap, Nguyen and team will analyze racial and ethnic disparities in the receipt of buprenorphine among Medicaid enrollees to inform targeted interventions focused on improving equity of buprenorphine treatment.

Impact of geography on abortion care access in Michigan

Lauren Owens

In 2022, the U.S. Supreme Court will decide a case that could restrict abortion services established in Roe v. Wade. In this scenario, Michigan residents seeking abortion care may need to travel out of state. Owens and team will analyze data on the distance to abortion care by Michigan county, identify areas that are most likely to be affected by a ban, and examine whether distance to abortion care is associated with county-level maternal morbidity, racial composition, and socioeconomic status. Using the data, the team will create resources to inform policymakers about opportunities to address inequities in reproductive healthcare access across the state.

Leveraging population-based surveillance to identify individuals with sickle cell disease eligible for expanded benefits through Children’s Special Health Care Services

Sarah Reeves

Sickle cell disease (SCD), a group of disorders that cause lifelong issues with pain, stroke, and infection, affects over 100,000 Americans, most of whom are racial and ethnic minorities. Much of SCD’s morbidity can be avoided with preventive services, including daily medications and annual screenings, however, individuals with SCD frequently experience barriers to these services. To improve access to SCD care, Reeves and team, in partnership with the Michigan Department of Health and Human Services (MDHHS), will implement population-based surveillance to identify adults with SCD in Michigan who are now eligible to receive coverage for care due to a recent expansion of a state health services program. 

COVID-19 Projects - Launched Summer 2020

Scale-up of COVID-19 diagnostic testing: A framework for decision-makers Ravi Anupindi headshot

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.

Angela Beck headshotWorkforce 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 Kao-Ping Chua headshot

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.

Kathleen and Chad headshots
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. 

Projects Launched Spring 2019

Using Claims Data to Estimate Mortality Associated with Large-Scale Disaster Among Older AdultsSue Anne Bell headshot

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.

Consumer Decision-Making About the Use of Health Savings AccountsJeff Kullgren headshot

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. 

TAVR Access and Quality Under New Medicare Coverage RulesMike Thompson headshot

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.

Tessa Watt and Thomas Cascino headshotImpact 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

Kao Ping Chua headshotDesign 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. 
     

Alex Peahl headshotImproving 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.

Michelle Moniz headshotShort-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.

 

chhabra sheetzSurprise 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.

Projects Launched Spring 2018

Voluntary Alternative Payment Models: Examining the Comprehensive Clena chen - norton headshotsare 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.

 
Jarman Reza MendezTobacco 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.

Staff Contact
Sarah Wang
Sarah Wang, M.P.H.
Policy Engagement Specialist
sjraby@umich.edu
734-647-5859