Front-line medical providers say Michigan’s Medicaid expansion helped patients’ health and ability to work

Extending medical insurance to low-income Michigan residents meant they had better access to health care, earlier detection of serious illnesses, better care for existing health problems and improved ability to work, attend school and live independently, according to a newly published survey of primary care providers.

Published in the Journal of General Internal Medicine by a team from the University of Michigan Institute for Healthcare Policy and Innovation, the results come from 2,104 primary care doctors, nurse practitioners and physician assistants who care for 12 or more people insured by the Healthy Michigan Plan, Michigan’s expansion of the Medicaid insurance program to low-income adults.

IHPI’s researchers conducted the survey as part of a contract with the Michigan Department of Health and Human Services to conduct the formal evaluation of the Healthy Michigan Plan required by the federal waiver that allowed Michigan to customize its Medicaid expansion.

The researchers note that the waiver allowed Michigan to require that new Medicaid expansion participants see a primary care provider within months of enrolling, and work with that provider to assess their health risks. The new findings suggest this could provide a model for other states currently considering expanding Medicaid, or working to expand it under recent policy decisions.

“While Michigan’s Medicaid expansion has been looked at as an example of financial incentives for healthy behavior, I think the primary care part of it is an underappreciated strength,” says Susan Goold, M.D., M.A., M.H.S.A., the professor of internal medicine who led the study. “Primary care practitioners said that people gained access to care they didn’t have before, including preventive services, and care for chronic conditions and other problems that they might otherwise have ended up in the emergency department for.”

One year after Medicaid expansion took effect in Michigan, the survey of primary care providers about their previously uninsured patients found:

74 percent said that Healthy Michigan Plan coverage had a positive impact on patients who have chronic diseases such as diabetes, asthma, heart disease and arthritis
71 percent said the coverage had led to earlier detection of serious illnesses in patients who had not previously been diagnosed; earlier detection can improve outcomes and reduce overall costs of care
69 percent said that patients stuck to their medication better because of their new insurance coverage; adherence to prescribed medicines can improve health outcomes
56.5 percent said their patients had improved their health-related behaviors. The Healthy Michigan Plan offers incentives such as gift cards and discounts to encourage participants to stop smoking, exercise more and engage in other healthy behaviors.
57 percent said coverage positively affected their patients’ emotional well-being
46 percent said coverage improved their patients’ ability to work or attend school
41 percent said patients’ ability to live independently improved because of their coverage

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