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 provide policymakers and stakeholders with timely and rigorous evidence to inform health policy and practice. Policy Sprint teams undertake rapid analyses to address important health policy questions, create products, such as policy briefs, to inform ongoing decision-making at the local, state, or national level, and engage with key policy audiences.

CURRENT PROJECTS

Can North Carolina’s Medicaid Expansion Reverse the Adverse Effects of Medicaid Unwinding on Buprenorphine Use? 

Effective December 1, 2023, in the middle of unprecedented state-wide disenrollment from Medicaid due to unwinding of continuous enrollment provisions, North Carolina expanded Medicaid eligibility under the Affordable Care Act. The research team will evaluate whether Medicaid expansion reversed the adverse effects of unwinding on buprenorphine use in the state, a medication for opioid use disorder.

 

Characterizing Cost-Sharing for Patient Portal Messages in Older Adults

Patient portal messaging allows individuals to communicate directly with their healthcare providers. Using data from the University of Michigan National Poll on Healthy Aging, this team will explore how older adults, a group that utilizes more healthcare services and may especially benefit from messaging providers after and between visits, experience cost-sharing for portal messages. This project has potential to inform policies that promote the equitable use of this digital health technology.

 

Evaluating State Policy Landscapes and Private Equity Acquisitions of Fertility Clinics

Private equity investment in the healthcare sector has grown rapidly over the past decade, leading to concerns around potential impacts on healthcare access, quality, and cost. The research team will examine the relationship between state laws and private equity acquisitions of fertility clinics in those states to inform policymakers about the effectiveness of various policy approaches to this emerging healthcare dynamic.

PAST PROJECTS & OUTCOMES

Cancer Care Theme

medication targeting cancer

Effect of the 340B drug pricing program on advanced prostate cancer care

This project will assess the effect of the federal 340B program, which requires that pharmaceutical companies sell medications at a steep discount to hospitals serving a high proportion of socioeconomically disadvantaged patients, on the use and out-of-pocket costs of oral targeted therapies among low-income and uninsured patients with advanced prostate cancer. 

Medicare part D coverage, meds, out of pocket costs

Evaluating out-of-pocket cost variability of cancer medications insured by Medicare Part D plans

Medicare Part D, a prescription drug benefit, offers the average Medicare beneficiary a choice of more than 50 different drug plans, some of which provide more coverage for cancer medications than others. The research team will evaluate out-of-pocket cost variability of common cancer medications across available Part D plans, then create educational materials about Part D cost-sharing requirements to help optimize plan selection and reduce out-of-pocket drug costs for patients. 

Health Equity Projects

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Use of Medications for Opioid Use Disorder After Overdoses Among Medicaid Enrollees

New research finds that medications for opioid use disorder were rarely prescribed following emergency department visits for opioid overdose among patients with Medicaid coverage. The U-M research team outlined key findings and policy considerations for policymakers and health systems to improve treatment initiation rates.

Imbalanced scale


Communicated Bias and Its Downstream Effects on Racial Inequities in Pain Treatment in the Emergency Department 

This project examined how health provider biases, such as pain-related stigma and racial discrimination, may be driving health inequities. The team measured potentially stigmatizing language used in triage notes for patients presenting to the emergency department with pain-related concerns, then determined whether differences in triage note language are associated with differences in health outcomes by race/ethnicity.

Red sickle cells

Leveraging Population-Based Surveillance to Identify Individuals with Sickle Cell Disease Eligible for Expanded Benefits through Children’s Special Health Care Services

Sickle cell disease (SCD) affects over 100,000 Americans, most of whom are racial and ethnic minorities. Much of SCD’s morbidity can be avoided with preventive services, however, individuals with SCD frequently experience barriers to these services. The U-M team, in partnership with the Michigan Department of Health and Human Services (MDHHS), implemented 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. 

A car traveling from MI to Chicago

Potential Impact of an Abortion Ban in Michigan on Driving Distance for Services

In June 2022, the U.S. Supreme Court reversed Roe v. Wade, returning jurisdiction over the regulation of abortion to the states. This project assessed the driving distance between each Michigan county and the closest abortion clinic if abortion remains legal and in the potential scenario of an abortion ban being enacted in Michigan.

 

COVID-19 Projects 

A therapist on a computer screen

Behavioral Health Provider Experiences with Telehealth in Michigan during COVID-19 

In response to the COVID-19 pandemic, federal and state policy changes were enacted to expand access to behavioral health telehealth services. This project examined providers' perspectives on telehealth policy changes, identifying barriers and assessing their perceptions of how telehealth use aided their work. 

COVID test

COVID-19 Testing Scale-Up: Key Issues and Considerations for Michigan Policymakers

Diagnostic testing has been critical to the COVID-19 public health response and associated economic recovery. This project identified bottlenecks within the COVID-19 diagnostic supply chain and provided operational and policy recommendations for effectively scaling up coronavirus testing to reopen the economy safely.

Teacher checking student's temp, wearing masks

Plans for School Attendance and Support for COVID-19 Risk Mitigation Measures

This policy sprint surveyed parents and guardians of school-aged children in Michigan, Illinois, and Ohio to better understand their perspectives on sending children back to school and support for COVID-19 risk mitigation strategies during the first year of the COVID-19 pandemic. 

Doc on computer and hospital

Telehealth Use in Michigan During COVID-19: Variation in Primary Care Telehealth Adoption and Its Impact on Emergency Department Use and Hospitalizations

The COVID-19 pandemic prompted many clinics across the U.S. to significantly reduce in-person visits and shift rapidly to telemedicine. This project assessed if variability in primary care providers’ uptake of telehealth was associated with rates of acute care use among their patients. 

 

Projects on Various Topics
 

Tornado and hurricane

After the Storm: The Health Impacts of Weather and Climate-Related Disasters on Older Adults in the U.S.

Deaths attributable to disasters are poorly understood and official mortality estimates have traditionally taken only direct causes into account, rather than considering contributing factors associated with a disaster that led to death. This project analyzed all-cause mortality in older adults after three major U.S. hurricanes.

Heart transplant and multiple hospitals

Examining Equity in Access to Heart Transplantation After 2018 Policy Changes

This project assessed 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.

Heart

Expanding Access to Transcatheter Aortic Valve Replacement (TAVR)

This project estimated 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.

A bottle of opioids next to a clipboard with a checklist

Opioid Prescribing Limits for Acute Pain

Opioid prescribing limits are an important component of the policy response to the U.S. opioid epidemic. This project highlighted design and implementation challenges of these emerging policies to regulate opioid prescribing and provided insight into how to minimize potential unintended effects.

A woman holding pregnant belly

Redesigning Prenatal Care during the COVID-19 Pandemic

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. This project identified key components of successful international prenatal care delivery models to inform state and federal policy discussions on improving prenatal care in the U.S.

A woman holding a small child

Short-Term Health Plans: State Options to Support the Health of Moms and Babies 

New regulations are increasing access to short-term health plans, which are required to cover essential health benefits such as contraceptive and maternity coverage. This policy sprint explored the potential effects of these policies on women’s health, summarizing potential policy options that states may consider undertaking.

A present next to a medical bill

Surprise Billing in Elective Surgery and Ground and Air Ambulance Transportation

Surprise medical bills are common in healthcare, arising when a patient chooses an in-network provider and facility but ends up receiving care from an out-of-network provider on the care team. This policy sprint examined the extent of out-of-network billing in surgical care and in ground and air ambulance transportation.

Tobacco 21 in Michigan: New Evidence and Policy Considerations

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This project examined the potential impact of Tobacco 21 policies, which aim to raise the minimum legal tobacco sales age to 21, on the health and well-being of Michigan residents, in addition to assessing potential tax revenue implications.

Health Savings Account icon

Use of Health Savings Accounts to Save for Health Care Expenses

Health savings accounts (HSAs) have been a centerpiece of federal health reform proposals. However, little is known about consumer behaviors and HSAs. This project identified which high-deductible health plan enrollees were more likely to have an HSA and why consumers forego opportunities to contribute to their accounts. 

A hospital building

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. This policy sprint aimed to understand which hospitals dropped out of one APM – the Comprehensive Care for Joint Replacement model -- after it transitioned from a mandatory to a voluntary program. 

  • Project lead: Lena Chen, M.D., M.S., Internal Medicine, Medical School
Staff Contact
Sarah Wang
Sarah Wang, M.P.H.
Policy Engagement Program Manager
[email protected]