IHPI funds policy-relevant research projects

The University of Michigan Institute for Healthcare Policy and Innovation (IHPI) is pleased to announce the awardees of its 2024 Policy Sprint initiative. 

The selected projects, chosen from many excellent proposals, will address gaps in knowledge related to Medicaid expansion and buprenorphine use, cost-sharing for patient portal messaging, and private equity acquisitions of healthcare entities. 

Each of the teams will receive up to $15,000 in funding, as well as guidance from IHPI policy engagement and communications staff. Paula Lantz, Ph.D., M.S., M.A., professor of public policy, will also advise the project teams in her role as faculty advisor for IHPI Policy Engagement and External Relations.

The projects launch in September 2024 and will conclude within six months. At the conclusion of their project, each team will produce a policy-relevant deliverable, such as an IHPI policy brief, video, commentary, or prominent blog post, to summarize their research findings and related policy considerations. IHPI staff will then help each team develop a strategy to engage with key policy audiences around their work.

The 2024 Policy Sprint projects and research teams are:

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

Project lead: Jeffrey McCullough, Ph.D., Health Management and Policy, School of Public Health

Team: Kao-Ping Chua, M.D., Ph.D., Pediatrics, Medical School, Joanne Constantine, Ph.D., Pediatrics, Medical School

During the COVID-19 pandemic, the Families First Coronavirus Response Act required state Medicaid agencies to keep beneficiaries enrolled in the program for the duration of the public health emergency. That requirement has since ended and states can disenroll people from Medicaid who no longer meet eligibility requirements or who do not complete the renewal process. As states unwind the continuous enrollment provision, many are concerned that access to care, including to treatment for opioid use disorder, may be negatively affected. 

Effective December 1, 2023, in the middle of unprecedented state-wide disenrollment due to unwinding, 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

Project leads: Terrence Liu, M.D., M.S., IHPI National Clinician Scholar, Internal Medicine, Medical School, Tammy Chang, M.D., M.P.H., M.S., Family Medicine, Medical School 

Team: Erin Isenberg, M.D., M.S., IHPI National Clinician Scholar, Chad Ellimoottil, M.D., M.S., Urology, Medical School, Jeff Kullgren, M.D., M.S., M.P.H., Internal Medicine, Medical School

Patient portal messaging allows individuals to communicate directly with their healthcare providers, offering a flexible way of receiving medical advice after and in between visits. This digital health technology has the potential to increase access to care, especially among certain groups, such as older adults who may face barriers to receiving care but often require more healthcare services due to multiple chronic conditions. 

Beginning in 2020, the Centers for Medicare and Medicaid Services introduced policies that allow clinicians to bill for complex portal messages that require clinician time for medical decision-making. Little is known about patient experiences with cost-sharing, and determining potential out-of-pocket costs can be challenging. Using data from the University of Michigan National Poll on Healthy Aging, this team will explore older adults’ experiences with patient portal messages to better understand billing and inform policies that promote the equitable use of this digital health technology.

Evaluating State Policy Landscapes and Private Equity Acquisitions of Fertility Clinics

Project lead: James Dupree, M.D., M.P.H., Urology, Medical School

Team: Vahakn Shahinian, M.D., M.S., Internal Medicine, Medical School

Private equity investment in the healthcare sector has grown rapidly over the past decade, with firms increasingly turning their attention to acquiring fertility clinics. There is increased scrutiny of private equity’s growing influence in healthcare, with concerns about potential impacts on healthcare access, quality, and cost. With little federal regulation in place, state laws and regulations are the primary policies impacting investments. 

The research team will examine the relationship between state laws and private equity acquisitions of fertility clinics in those states, an area which has not been studied to date. This project has the potential to inform policymakers at the state and federal level about the effectiveness of various policy approaches to this emerging healthcare dynamic.