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.
Health Equity Theme (launched Spring 2022)
Communicated Bias and Its Downstream Effects on Racial Inequities in Pain Treatment in the Emergency Department
This project will examine how health provider biases, such as pain-related stigma and racial discrimination, may be driving health inequities. The team will measure potentially stigmatizing language used in triage notes for patients presenting to the emergency department with pain-related concerns, then determine whether differences in triage note language are associated with differences in health outcomes by race/ethnicity.
- Project leads: Pooja Lagisetty, M.D., M.Sc., General Medicine, Medical School, Christopher Fung, M.D., Emergency Medicine, Medical School
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), 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.
- U-M project lead: Sarah Reeves, Ph.D., M.P.H., Pediatrics, Medical School
- Resulting publication: IHPI Policy Brief (December 2022)
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.
- Project lead: Lauren Owens, M.D., M.P.H., Obstetrics and Gynecology, Medical School
- Resulting publication: IHPI Policy Brief (October 2022)
Racial and Ethnic Disparities in Timely Treatment Initiation Following Emergency Department Visits for Non-Fatal Opioid Overdose
Buprenorphine, a medication for opioid use disorder (OUD) that substantially decreases fatal overdose risk, remains widely underused. Moreover, little is known about buprenorphine treatment among the 38% of low-income adults with OUD covered by Medicaid. This project 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.
- Project lead: Thuy Nguyen, Ph.D., M.P.A., Health Management and Policy, School of Public Health
PAST PROJECTS & OUTCOMES
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.
- Project lead: Angela Beck, Ph.D., M.P.H., Health Behavior and Health Education, School of Public Health
- Resulting publications: IHPI Policy Brief (January 2021), U-M press release (January 2021), Behavioral Health Workforce Research Center Report (January 2021)
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.
- Project lead: Ravi Anupindi, Ph.D., M.E., M.S., Technology & Operations, Stephen M. Ross School of Business
- Resulting publications: IHPI Policy Brief (October 2020), U-M press release (October 2020)
- Informing policy: Written testimony to the US Senate Committee on Homeland Security and Governmental Affairs, following a hearing titled “COVID-19 Part II: Evaluating the Medical Supply Chain and Pandemic Response Gaps" (May 2021)
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.
- Project lead: Kao-Ping Chua, M.D., Ph.D., Pediatrics, Medical School
- Resulting publications: IHPI Policy Brief (June 2020), U-M press release (June 2020), Academic Pediatrics (November 2020)
- Featured in: Click on Detroit (June 2020), Detroit Free Press (June 2020), MLive (June 2020), Bridge MI (June 2020), USA Today (July 2020)
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.
- Project leads: Kathleen Li, M.D., Emergency Medicine, Medical School; Chad Ellimoottil, M.D., M.S., Urology, Medical School
- Resulting publications: IHPI Policy Brief (March 2021), U-M press release (March 2021), JAMA Network Open (March 2022)
- Informing Policy: Cited in Bipartisan Policy Center Report: The Future of Telehealth After COVID-19 (October 2022)
Projects on Various Topics
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.
- Project lead: Sue Anne Bell, Ph.D., M.S.N., M.Sc., FNP-BC, Health Behavior and Biological Sciences, School of Nursing
- Resulting publications: IHPI Policy Brief (February 2020), Cambridge University Press (November 2020), U-M press release (December 2020)
- Informing Policy: Provided oral testimony, Senate Special Committee on Aging hearing, “Inclusive Disaster Management: Improving Preparedness, Response, and Recovery” (November 2021)
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.
- Project lead: Thomas Cascino, M.D., Cardiac Surgery, Medical School
- Resulting publications: IHPI Policy Brief (November 2021), The Journal of Heart and Lung Transplantation (September 2021)
- Informing policy: Cited in NASEM Report: Realizing the Promise of Equity in the Organ Transplantation System (2022)
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.
- Project lead: Michael Thompson, Ph.D., Cardiac Surgery, Medical School
- Resulting publications: IHPI Policy Brief (May 2020), U-M press release (April 2020), JAMA Cardiology (April 2020)
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.
- Project lead: Kao-Ping Chua, M.D., Ph.D., Pediatrics, Medical School
- Resulting publications: IHPI Policy Brief (May 2020), U-M press release (March 2020), JAMA Surgery Viewpoint (March 2020)
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.
- Project lead: Alex Friedman Peahl, M.D., Obstetrics and Gynecology, Medical School
- Resulting publications: American Journal of Obstetrics & Gynecology (January 2020), U-M press release (March 2020), Obstetrics & Gynecology (May 2020)
- Related events: Featured in ACOG webinar, in collaboration with IHPI: Engaging Community in Redesigning Prenatal Care (January 2020)
- Informing policy: Cited in Birthing While Black: Examining America’s Black Maternal Health Crisis House Oversight and Reform Hearing (May 2021)
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.
- Project lead: Michelle Moniz, M.D., M.Sc., FACOG, Obstetrics and Gynecology, Medical School
- Resulting publication: IHPI Policy Brief (April 2019)
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.
- Project lead: Karan Chhabra, M.D., Surgery, Medical School
- Resulting publications: Surprise billing in elective surgery: IHPI Policy Brief (February 2020), Q&A (February 2020), Michigan Health Lab press release (February 2020), JAMA (February 2020), Annals of Surgery, Clinical Report (May 2020), NEJM Perspective (April 2021); Surprise billing in ground and air ambulance transportation: Health Affairs Forefront (October 2019), Health Affairs, research article (April 2020), IHPI press release (May 2020)
- Featured in: NPR Shots (February 2020), The New York Times (February 2020), USA Today (February 2020), US News (February 2020), The Atlantic (February 2020), US News (May 2020), Tradeoffs Podcast (September 2020), The New York Times (October 2020), IHPI press release: When research translates to policy change: A “surprise billing” marathon (March 2021)
- Informing policy: Cited in ASPE HHS Secretary's Report on Addressing Surprise Medical Billing (July 2020), the interim final rule on Requirements Related to Surprise Billing Part 1 (July 2021), ASPE Office of Health Policy Issue Brief: Air Ambulance Use and Surprise Billing (September 2021), ASPE Office of Health Policy Issue Brief: Evidence on Surprise Billing: Protecting Consumers with the No Surprises Act (November 2021), Bipartisan Policy Center Report: Improving and Strengthening Employer-Sponsored Insurance (October 2022)
Tobacco 21 in Michigan: New Evidence and Policy Considerations
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.
- 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
- Resulting publications: IHPI Policy Brief (March 2019), White Paper (March 2019), U-M press release (March 2019), IHPI video (March 2019), BMJ Blog (June 2019), Op-Ed, The Hill (May 2019)
- Featured in: Michigan Stateside Interview (April 2019), Wisconsin Public Radio (April 2019)
- Cited in: MDHHS Michigan Tobacco 21 Talking Points, MDHHS Online Tobacco Resources Library
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.
- Project lead: Jeffrey Kullgren, M.D., M.S., M.P.H., Internal Medicine, Medical School
- Resulting publications: IHPI Policy Brief (August 2020), U-M press release (August 2020), JAMA Network Open (July 2020)
- Featured in: The New York Times (March 2021)
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