04 Jun 2025
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MVC Welcomes Its New Project Manager, Emily Woltmann, PhD, MSW

MVC Welcomes Its New Project Manager, Emily Woltmann, PhD, MSW

June 4, 2025 | 0 Comments |

I'm thrilled to join the Michigan Value Collaborative (MVC) as a project manager, supporting MVC’s value-based initiatives in cardiac rehabilitation and pre-operative testing, and more. The enthusiasm, thoughtfulness, and dedication of the team has impressed me, and I look forward to contributing my experiences to our efforts.

My interest in the gap between accessible, high-quality healthcare and patient and provider experiences was sparked during my early career as a community mental health worker. The lack of effective psychosocial treatment options often left me feeling ill-equipped to assist my clients. This motivated me to pursue a Master’s Degree in Social Work (MSW) at the University of Michigan, with a focus on policy analysis and program evaluation in the mental health setting. I was surprised to discover that many evidence-based treatments existed but were unavailable outside academic settings. This realization led me to dedicate my career to understanding and bridging this disconnect.

After working as a research associate at the VA Ann Arbor Veterans Administration Medical Center, I pursued a PhD at the Dartmouth Institute for Health Policy and Clinical Practice. While there I worked on the first national demonstration project implementing evidence-based practices in community mental health settings in the United States. My research focused on the role of workforce instability in implementing evidence-based practices and the development of an electronic decision support system to aid shared decision-making between care managers and patients.

Following this, I continued my implementation science research at the Ann Arbor VA, University of Michigan, and as an assistant professor at the Brown School at Washington University in St. Louis. I then took a career break to focus on family responsibilities.

In 2022, I re-entered the workforce, joining the Department of Learning Health Sciences at the University of Michigan Medical School. I worked on a study examining strategies for implementing a cardiovascular risk reduction intervention for patients in community mental health settings. Later, I transitioned to the Division of General Medicine at UM, managing quality improvement projects in primary care clinics. This role solidified my desire to focus my efforts more fully on the quality improvement field.

I look forward to contributing further to enhancing healthcare quality and value in Michigan through my role at MVC. Please feel free to contact me with any questions at ewoltman@med.umich.edu.

28 May 2025
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Refreshed Hospital-Level, ED-Based Episode Push Reports Released April 2025

Refreshed Hospital-Level, ED-Based Episode Push Reports Released April 2025

May 28, 2025 | 0 Comments | , ,

The MVC Coordinating Center distributed refreshed hospital-level versions of its push report utilizing emergency department-based episodes (“ED-based episodes”) in April, preparing versions for acute care hospitals and Critical Access Hospitals to include different comparison groups. The report leverages data focused specifically on patient episodes first initiated by a visit to the emergency department and follows those episodes to determine common metrics such as episode payments, post-ED care utilization, and outpatient service rates.

In addition to reflecting more recent data across all included payers, these refreshed hospital-level reports provide additional social risk data than was offered previously with the addition of several metrics based on patient Zip code to the patient population snapshot table. This allows hospitals to better understand the patients represented in various service line cohorts presented within the ED-based episodes report and the types of social risk factors that may be present, such as low median household income, SNAP usage, vehicle ownership, and homeownership.

Each page of the report is dedicated to a specific condition with mostly the same metrics throughout, such as risk-adjusted, price-standardized 30-day total episode spending, inpatient admission rates, and rates of post-ED utilization. Reports feature each hospital’s own attributed ED-based episode data for eight high-volume ED conditions: abdominal pain, cellulitis, chest pain (nonspecific), congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes with long-term complications (including renal, eye, neurological, or circulatory), diabetes with short-term complications (including ketoacidosis, hyperosmolarity, or coma), and urinary tract infection (UTI).

Among general acute care hospitals receiving a report, the average risk-adjusted, price-standardized 30-day total episode payment (Figure 1) for the reported conditions is highest for diabetes with long-term complications ($21,031), followed by CHF ($18,363), diabetes with short-term complications ($12,571), and COPD ($11,145). The collaborative-wide average total episode payment is lowest for chest pain ($3,327) and abdominal pain ($3,405). These rankings are consistent with the 2024 ED-based episode reports.

Figure 1.

A key goal of these reports is to provide insights into healthcare utilization following index ED events; therefore, the latest reports continue to include a dot plot (Figure 2) comparing patient post-ED utilization at a member hospital against their peer comparison group. Dot plots provide information on what percent of episodes had a same-day inpatient admission, what percent did not have a same-day inpatient admission but did see the patient admitted in the 1 to 30 days following the index ED visit, and the percent of patients who had two or more inpatient admissions (thus, at least one readmission) during the episode of care. Rates of subsequent ED visits, outpatient services, home health, skilled nursing facility care, and inpatient or outpatient rehab are also provided.

Figure 2.

MVC uses its most recent medical insurance claims data from Medicare FFS, Blue Cross Blue Shield of Michigan PPO Commercial and Medicare Advantage plans, Blue Care Network HMO Commercial and Medicare Advantage plans, and Michigan Medicaid to build these ED-based episodes reports.

MVC recently presented data on the incidence of behavioral health co-diagnoses on ED-based episodes at its May collaborative-wide meeting. This presentation highlighted the presence of behavioral health ICD-10 codes on index ED visits for patients with a primary diagnosis code matching one of MVC’s ED conditions. MVC reported 13% of ED index events statewide contained a behavioral health code. The most common codes observed were for anxiety disorder (36.7%), major depressive disorder (10.6%), and dementia (8.7%). The recent ED-based episode reports include a row for “most frequent comorbidities” by condition, which will help members determine service lines where psychological disorders or substance abuse disorders are a common consideration for specific service lines at their hospital.

MVC’s ED-based episode structure was developed in collaboration with the Michigan Emergency Department Improvement Collaborative (MEDIC), a BCBSM-funded Collaborative Quality Initiative with the goal of improving care and patient outcomes in Michigan emergency departments. MVC and MEDIC team members worked closely to develop 30-day episodes of care initialized by a patient’s visit to the ED and including all claims-documented care received in the 30 days following a patient’s index ED visit.

Please share your feedback with the MVC team if certain report measures are helpful or if you wish to see additional ED-based episode reporting for certain conditions and metrics. MVC is now also accepting custom report requests using its ED-based data. Contact MVC to learn more.

21 May 2025
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April Workgroups Highlight Preoperative Testing and MVC’s Process Measures Report & Registry Review

April Workgroups Highlight Preoperative Testing and MVC’s Process Measures Report & Registry Review

May 21, 2025 | 0 Comments | , , ,

In April, MVC hosted two virtual workgroup presentations – the first, a preoperative testing workgroup focused on the CQI collaboration with the Michigan Surgical Quality Collaborative (MSQC) to reduce preoperative testing rates for low-risk surgeries, supplemented by a brief overview of the RITE-Size Initiative and how MVC sites can benefit from participating. The second workgroup, health in action, focused on the recent MVC Process Measure Report and included an overview of how to utilize the MVC registry. The MVC Coordinating Center hosts workgroup presentations twice per month covering a variety of topics including post-discharge follow-up, sepsis, cardiac rehab, rural health, preoperative testing and health in action.

Preoperative Testing Workgroup 4/8/2025

Jennifer Bennett, MBA, BSN, RN, Lead Quality and Patient Safety Coordinator for Henry Ford Health (HFH) Madison Heights – Warren, shared that in 2017 the estimated cost for unnecessary preoperative testing and treatment was $200 billion nationwide (Healthcare Finance News, 2017). Additionally, in 2014, PerryUndem and the Choosing Wisely Campaign completed a phone survey of over 600 different physicians (primary care and specialists) across the country. This survey inquired whether providers believed unnecessary tests and procedures in the healthcare system were a serious problem and who or what entity should be responsible for leading improvement efforts.

Results showed that the top reasons providers ordered the unnecessary tests were because of malpractice concerns, belief that it should be done “just to be safe,” patients insisting on having the test, or they were trying to keep patients happy (Figure 1). Providers also believed they were the best suited to address overuse of unnecessary tests and procedures in the healthcare system.

Figure 1. Reasons Why Physicians Order Unnecessary Tests

Physicians surveyed selected several solutions to try and address the issue including malpractice reform, having specific evidence-based recommendations in a format that would be easy to discuss with the patient, having more time to discuss alternatives with patients, and changing the system of financial rewards for preoperative testing metrics (Figure 2).

Figure 2. Possible Preoperative Testing Reduction Strategies Poll

In collaboration with MSQC, Henry Ford Health Madison Heights-Warren launched a pilot program in 2023 to implement appropriate preoperative screening for low-risk surgeries, including breast lumpectomy – partial mastectomy, minor hernia, and laparoscopic cholecystectomy. Initial data used for setting a baseline understanding showed that preoperative testing rates for these procedures across the state had a wide range of 8% - 85%, and testing before low-risk surgeries was noted to be common for greater than 50% of patients undergoing at least one test.

Using testing recommendations from several notable academic medical societies, Henry Ford and MSQC were able to build an outline of recommendations for blood work (labs), electrocardiogram (ECG) tests, cardiac stress tests, and chest x-rays. A decision tree was developed to aid providers in choosing a test that was appropriate for a patient prior to their procedure (Figure 3).

Figure 3. Suggested Pre-op Testing Decision Aid for Low-Risk Surgeries

This decision tree took into consideration what American Society of Anesthesiologist (ASA) class the patient fell under. The ASA classes (ASA 1 – 5) are determined by physical status of the patient (Do they have comorbidities, age related issues, life expectancy if they don’t have the procedure, etc.?) The higher the ASA class level the more likely the patient will require additional testing due to chronic disease processes being present. Recommendations for preoperative testing on patients that are an ASA class 3 or above were combined into a guidance chart (Figure 4) to aid in test order decision making.

Henry Ford Health Madison Heights-Warren reported several successes during their pilot program. These include:

  1. Engaging stakeholders: They successfully engaged various stakeholders—including patients, providers, office staff, CQIs, and IT—in meaningful conversations and collaborative problem-solving.
  2. Acknowledging work: The team emphasized the critical importance of the work being done and its alignment with the best interests of patients.
  3. Cost savings: They highlighted the potential for significant overall cost savings resulting from the program's implementation.
  4. Revising protocols: Protocols were revised to incorporate new best practices for preoperative testing, ensuring enhanced care quality.

Some of the barriers that arose included communication breakdowns, a lack of education or understanding, trying to engage and include providers that were contracted private practice and may not have the same electronic medical record (EMR) access, and not having a complete set of data due to claims data delays (Medicare/Medicaid).

Results

Prior to the pilot program launching (March 2022 - March 2023), HFH Madison Heights-Warren's preoperative testing rates were at 37.8% and after implementation (March 2023 – September 2024) their preoperative testing rate reduced to 31%. Their next steps include partnering with the RITE-Size initiative to develop future preoperative testing goals and re-engaging with stakeholders at other Henry Ford Health sites.

RITE-Size Initiative Overview

MVC Program Director Hari Nathan, MD, PhD, gave a brief overview of the RITE-Size initiative. The goal for right-sizing testing before elective surgery is to identify patient risk-level, match patient risk-level to pre-op testing, and perform a safe and successful low-risk surgery. This initiative is a grant funded collaborative partnership between Michigan Surgical Quality Collaborative (MSQC), Michigan Value Collaborative (MVC), and the Michigan Program on Value Enhancement (MPrOVE) (Figure 5). The plan is to learn from the clinical and claims data, consider clinician input, and to recommend high-value tests based on this information.

Figure 5. RITE-Size Offerings

If your site is interested in participating in the RITE-size preoperative testing program, please reach out by email to the MVC Coordinating Center.

Health in Action Workgroup – MVC Process Measures Report & Registry Review 4/24/25

The health in action workgroup featured a presentation by MVC’s Site Engagement Coordinator Emily Bair, MS, MPH, RDN, CSP. The presentation focused on the recent MVC Process Measure Report and included an overview of how to utilize the MVC registry.

Traditionally, MVC push reports have focused on just one condition, surgery, or metric at a time. The process measures push report was developed to pull together information on multiple conditions to provide individualized, comprehensive, and actionable insights for MVC members (Figure 6). This report was provided to sites that are participating in the MVC portion of the BCBSM P4P program as well as non-P4P sites. This allows sites to evaluate their progress on all eligible measures, not just the metrics selected for the P4P program year.

Figure 6. MVC Conditions

This process measures report includes 90-day inpatient or surgical episodes created from index admissions between January 2022 – December 2023. Exclusions included patients who had an inpatient hospital transfer, died in the hospital during their index hospitalization, or were discharged to hospice. Payors included Blue Care Network HMO, commercial and Medicare Advantage, Blue Cross Blue Shield of Michigan PPO commercial, and Medicare Advantage, Medicare, and Michigan Medicaid.

Within the report each site has an individualized sociodemographic overview table that displays the patient population for each process measure cohort (Figure 7). This table illustrates the distribution pattern of the population within each process measure but is not necessarily indicative of the distribution of patient demographics for the outcome of interest. One detail to note is that the race/ethnicity denominator includes all patients but may not add up to 100% due to the exclusion of other race/ethnicity categories.

Figure 7. MVC Process Measure Report for Hospital A (blinded data)

In addition to race/ethnicity categories, MVC is populating data on patient zip codes (categorized as prosperous, comfortable, mid-tier, at-risk, or distressed according to the Economic Innovation Group’s Distressed Communities Index (DCI) 2015-19. The DCI incorporates economic indicators such as education, employment, and income as well as patient age and gender. These are some of the first steps being taken to incorporate sociodemographic information into our analyses, deepening our understanding of the patient community's needs and awareness to support further health equity efforts.

Registry Review

How can we use the MVC registry to investigate certain metrics or patient demographics?

  1. Search for specific metrics such as preoperative testing rates at your site. Are they higher or lower than the MVC All average?
  2. Investigate certain procedures for which tests are being ordered more frequently than others
  3. Drill down to see if certain patient age categories are accumulating a higher testing rate than others

For example, when looking at the multi-payer preop testing reports, helpful filters to utilize would be the following:

  1. Episode start dates – selecting an exact date range
  2. Payers – choosing the appropriate payers for the date range you are looking at (noting that Medicare and Medicaid data may be 6 months to 1 year behind BCBSM)
  3. Procedures – choose the desired procedure(s) you want to investigate
  4. Tests – choose the desired tests you want to investigate in relation to the procedure
  5. Patient characteristics – choose what age(s), gender, race/ethnicity, and comorbidities you want to include/exclude

Interested in joining the MVC registry?

Once you send a registry request the MVC team will confirm your request with your specified site’s MVC Site Coordinator (primary contact). Once confirmed you will be sent the MVC website confidentiality agreement (WCA), and upon receiving the completed WCA, MVC will provide a username and directions to login in via email.

If you are interested in pursuing a healthcare improvement program, MVC has data specialists available to help navigate and create custom analytics reports. Please reach out to us by email if you would like to learn more about MVC data or engagement offerings!

14 May 2025
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MVC 2025 Spring Collaborative-Wide Meeting Summary

MVC 2025 Spring Collaborative-Wide Meeting Summary

May 14, 2025 | 0 Comments | , , , ,

Collaboration in Action: Shaping the Future of Healthcare Across Michigan

The Michigan Value Collaborative (MVC) held its spring 2025 collaborative-wide meeting on Friday, May 9, in Midland. A total of 106 attendees representing 62 hospitals, 6 physician organizations, 6 Collaborative Quality Initiatives (CQIs), and 11 healthcare systems from across the state of Michigan came together to build partnerships and collaborate on approaches to healthcare delivery that will have a long-lasting impact.

MVC Director Dr. Hari Nathan kicked off Friday’s meeting with updates on the MVC Coordinating Center [. He introduced MVC’s newest team members, senior analysts Steven Ellinger and Tanima Basu, and Program Assistant Dinah Pollard. Dr. Nathan also announced the promotion of Jana Stewart to Associate Program Manager and welcomed Dr. Jessica Golbus as the new Co-Director of the Michigan Cardiac Rehab network (MiCR). He provided an update on recruitment progress for Phase II of the RITE-Size pilot and encouraged sites interested in participating to reach out to the MVC Coordinating Center. Dr. Nathan concluded the welcome presentation by highlighting MVC reporting updates. These included new multi-payer preoperative testing dashboard reports added to MVC’s data registry in Q4 of 2024, and five hospital-level push reports with data reflecting P4P Program Year (PY) 2026-2027 selections, statewide health equity, process measures, P4P PY 2024 final scorecards, and ED-based episodes.

Managing Director Mark Bradshaw, MSc, presented a summary of PY 2024 scoring and PY 2026-2027 selections for the MVC Component of the BCBSM P4P Program [SEE SLIDES]. In his summary of PY 2024 scoring, Bradshaw highlighted opportunities for members to leverage MVC resources to optimize P4P scores via MVC’s engagement point menu options and highlighted some of the value metrics that have seen success after their first year of scoring.

The overview of MVC members’ P4P selections included a comparison of the value metric selections that were made for the PY 2024-2025 vs. the PY 2026-2027 program cycles (Figure 1). Bradshaw also reviewed MVC’s new health equity measure and index of disparity before closing with a reminder about upcoming dates relevant to participating P4P hospitals (Figure 2).

Figure 1.

Figure 2.

The meeting then featured MVC’s first Engagement Awards, presented by MVC Engagement Manager Jessica Souva, MSN, RN, C-ONQS. MVC presented the awards to members who went above and beyond in their engagement with MVC to the benefit of the entire MVC membership. Scheurer Health received the award for the most engaged peer group 5 hospital, MyMichigan Collaborative Care organization for the most engaged physician organization (PO), Chelsea Hospital for the most engaged hospital, and Corewell Health for the most engaged health system.

Souva remained at the podium for a presentation on MVC’s 2024 Quality Improvement (QI) survey, sharing details about the survey’s purpose, completion rate, results, and applications [SEE SLIDES]. The four most widely reported QI initiatives included sepsis, health equity, readmissions, and emergency department care, and also aligned with the initiatives reported as highest priority for some of the largest health systems in Michigan (Figure 3). Souva provided specific examples of MVC engagement activities that were developed to specifically support the initiatives reported in the QI survey and address common barriers members reported facing. She urged MVC’s PO members to participate in the 2025 QI survey so that MVC will be better equipped to provide support for PO QI initiatives in the future.

Figure 3.

Before sending meeting attendees to participate in the poster session, Souva shared the responses from the opening virtual ice-breaker question: “What keeps you motivated to continue working in healthcare?” Members credited their teams and making a difference in the lives of patients and families as their motivation to persevere during challenging times. Posters were then presented by partner CQIs such as MEDIC, MOQC, MSHIELD, and MI Mind. Electronic copies of the posters are available on the spring meeting website [LINK]. The MVC Coordinating Center would like to thank all poster presenters for sharing their work.

After the poster session, MVC Associate Program Manager Jana Stewart, MPH, provided a presentation highlight the ways in which MVC collaboratives with other CQIs to help drive local quality improvement efforts in hospitals across Michigan. This included two case studies and unblinded data presentations for MVC’s two value-based initiatives: cardiac rehabilitation utilization and preoperative testing de-implementation. She also presented a use case for a new area MVC is exploring within its ED-based episodes of care focused on behavioral health care and outcomes, also with aggregate and hospital-level unblinded data.

Since the launch of MVC's cardiac rehabilitation initiative in 2020, the work has been incorporated into all aspects of MVC’s portfolio, from dedicated workgroup topics to reporting and related P4P metrics, and it also led to the 2022 launch of MiCR in partnership with BMC2 and the NewBeat program in partnership with HBOM. Cardiac rehabilitation enrollment for patients discharged from a “Main 5” condition (e.g., AMI, CABG, PCI, SAVR, and TAVR), has increased across the collaborative from 24% in 2020 to 34% in 2023, amounting to an estimated 145 lives saved and 243 readmissions avoided. Stewart also shared that the mean days to a patient’s first cardiac rehabilitation visit has decreased from 59 days in 2020 to 46 days in 2024.

Highlights from MVC’s preoperative testing efforts included updates on the RITE-Size pilot—a collaboration largely between MVC, MPrOVE, and MSQC—that supported three MVC member hospitals in reducing their low-value preoperative testing rates in 2024 through a variety of strategies. Stewart called out that members interested in participating in Phase II of the pilot in 2025 or 2026 will be well positioned to both reduce their testing rates significantly and also achieve the full two engagement points for 2025. She encouraged anyone interested to reach out to the MVC Coordinating Center for additional information.

Stewart concluded by sharing aggregate and unblinded data on the prevalence of behavioral health as a co-diagnosis in MVC ED-based episodes, where behavioral health ICD-10 codes such as anxiety disorder, major depressive disorder, and dementia appear as co-diagnoses (Figure 4) in approximately 13% of index ED events. She also shared how those behavioral health rates differ by payer as well as condition and noted that 1 in 3 of ED patients who have a resulting inpatient admission have a behavioral health code noted as a comorbidity.

Figure 4.

After a networking lunch, attendees spent the afternoon participating in roundtable discussions and small group activities on two to three topics [SEE ROUNDTABLE MATERIALS]. During the session, attendees could either join three roundtable discussions or join one roundtable and one small group activity on system approaches to QI. At each table attendees learned about the work of the roundtable facilitator, asked questions, and discussed similar initiatives at their own organizations. In the system activity, MVC members were asked a series of questions about measuring system-level QI, and their responses will help inform MVC’s future work to support health systems across Michigan.

The meeting closed with a reflection of the day spent together, reminders about upcoming meetings, and opportunities for best practice sharing with other MVC members.

If you have questions about any of the topics discussed at MVC’s spring collaborative-wide meeting or are interested in following up for more details, contact the MVC Coordinating Center. MVC’s next collaborative-wide meeting will be in person on Fri., Oct. 10, 2025, in Livonia.

 

30 Apr 2025
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MVC Virtual Networking Event: Collaborative Learning in Post-Discharge Follow-up for Sepsis Patients

MVC Virtual Networking Event: Collaborative Learning in Post-Discharge Follow-up for Sepsis Patients

April 30, 2025 | 0 Comments | , , ,

On April 16, 2025, MVC hosted a virtual networking event providing members with an opportunity to make professional connections and discuss strategies for improving post-discharge follow-up for sepsis patients. Forty-six MVC members from thirty-three hospitals and seven health systems participated in the ninety-minute event. 

The event kicked off with an ice breaker activity (Figure 1) and an interactive quiz on common sepsis patient demographics, symptoms, and discharge care best practices.  

Figure 1

Prior to starting the breakout discussion groups, MVC’s Engagement Manager, Jessica Souva, MSN, RN, C-ONQS presented unblinded hospital-level 14-day follow-up after sepsis rates for 30-day inpatient episodes from July 1, 2023, to June 30, 2024. 

The breakout discussions were structured to engage attendees in conversations about challenges and strategies to addressing barriers in patient follow-up after sepsis. This goal was accomplished by providing groups with specific scenarios and types of approaches to improve follow-up after discharge for sepsis patients (Figure 2)

Figure 2

What challenges are MVC members facing related to follow-up after discharge for sepsis patients? 

MVC members reported that sepsis patients often face challenges in scheduling follow-up appointments, not knowing when to contact their provider for early warning signs and being readmitted before their scheduled post-discharge follow-up appointments. Contributing factors include lack of provider ability, incomplete patient or family education, and sub-optimal discharge dispositions.  

What are MVC members doing to improve their rates of follow-up after discharge for sepsis patients?  

During the breakout discussions, attendees shared that they are addressing the identified challenges through a multifaceted approach focusing on patient education, communication, resource access, team collaboration, and data evaluation. 

Patient Education and Empowerment 

  1. Discharge Paperwork: Include a phone number for patients to call with questions or concerns and to schedule follow-up appointments. This allows patients to seek follow-up care sooner. 
  2. Family Involvement: Educate and involve family members to facilitate follow-up care by ensuring they understand the importance. 
  3. Empowering Survivor Stories: Share stories from patient survivors through interviews, surveys, or patient advisory councils. These stories can be used to educate current patients, their families, and providers. 

Communication and Coordination 

  1. Care Coordinator/Nurse Navigator: Assign a care coordinator or nurse navigator as the point of contact post-discharge. Care Coordinators and Nurse Navigators can help patients understand factors influencing readmission and how to mitigate these factors. 
  2. Continuous Communication: Maintain open communication between inpatient and outpatient case managers regarding transitions of care. 
  3. “Call Back Crew”: Build a team to follow up with patients, reinforce education, and use call centers to identify trends and improve follow-up processes. 

Resource Access 

  1. Scheduling Follow-Up Appointments: When possible, schedule follow-up appointments before discharge. 
  2. Discharge Clinics: Block time for a dedicated provider to staff a clinic for patients who do not have or are unable to get an appointment with their PCP. This type of clinic can reduce return ED visits and readmissions by providing support, education, and resources. 
  3. Educate Staff About Under-utilized Resources: Local Area Agencies on Aging can facilitate access to free or low-cost services to improve the home setting for patients aged 65+. Many insurance providers, like Medicare Advantage/BCBSM provide additional support post-discharge with designated case managers.  

Team Collaboration and Internal Processes 

  1. Multi-Disciplinary Approach: Include care management and various therapies to support patient recovery. Ensure all patients receive a physical and occupational therapy evaluation to screen basic functional needs before discharge and determine the best future care setting. 
  2. Unified Team Message: Ensure therapy, physician, and care management teams provide a unified message to patients. 
  3. Improve Team Reliability and Training: Build internal trust and, consequently, patient trust. Provide physicians with training on how to conduct difficult discussions with patients and their families, ensuring patients understand their situation and the benefits of alternative approaches when recommended by medical professionals. 

Data and Evaluation 

  1. Patient Interviews and Surveys: Include a readmission nurse on the patient care team to interview readmitted patients and learn from their experiences.  The readmission nurse can act as a liaison between quality and hospital care teams, highlighting patients needing special attention and collecting feedback. 
  2. Retrospective Review: Complete a retrospective review of the patient’s journey to identify improvements needed in education and communication upon readmission for the same reason. 
  3. Care Transition Programs: Add sepsis patients to Care Transition Programs to trigger alerts for retrospective review of readmission cases and to identify improvement areas. 

What are members saying about the MVC April Virtual Networking Event? 

  • “Very fun and informational event. I like the smaller break out sessions to foster meaningful conversation and then bringing the ideas of the smaller groups to the entire group.” 
  • “Very well organized. I loved the interactive piece.” 
  • “I enjoyed the pre-break out group survey/quiz questions to help with engagement…it is less intimidating to speak up in the smaller groups than when everyone is in on large group.” 
  • “I enjoyed the networking aspect of this event and look forward to others in the near future. MVC Site Engagement Coordinators did a wonderful job facilitating this event and engaging the participants.” 
  • “It was reassuring to hear that many of the hospitals across the state are having the same issues and working on similar projects. It gave me a sense that my own hospital is on the right path.” 

MVC looks forward to hosting more virtual networking events throughout the year to increase collaboration and connection with MVC’s members. If your hospital or organization has a networking topic they would like to share, please email us. We would love to hear from you.   

23 Apr 2025
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MVC Announces Agenda, Speakers for Spring Collaborative-Wide Meeting

MVC Announces Agenda, Speakers for Spring Collaborative-Wide Meeting

April 23, 2025 | 0 Comments | , , ,

The MVC Coordinating Center is excited to announce the agenda for its spring collaborative-wide meeting on Fri., May 9, 2025, from 10 a.m. – 3 p.m., at the H Hotel in Midland, MI. This meeting’s theme of “collaboration in action” reflects a focus on partnerships, collaborating to overcome barriers, and leveraging data to shape improvement projects. Those interested in attending MVC's spring collaborative-wide meeting can learn more and register here.

MVC Director Hari Nathan, MD, PhD, and Managing Director Mark Bradshaw, MSc, will kick off the day with Coordinating Center updates as well as announcements about the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay-for-Performance (P4P) Program. This will be followed by a new engagement awards ceremony and a presentation about statewide trends in quality improvement efforts, both presented by MVC Engagement Manager Jessica Souva, MSN, RN, C-ONQS.

The meeting includes a mid-morning poster session with 11 presenters highlighting success stories and research across the broader CQI portfolio. This is one of several opportunities to network with peers.

MVC Associate Program Manager Jana Stewart, MS, MPH, will present on recent MVC partnerships with other CQIs that drove site-level quality improvement initiatives. In addition to providing updates on these partnerships and their respective progress, Stewart will also share new priorities related to cardiac rehabilitation, preoperative testing, and ED-based episodes of care. This presentation will include unblinded data on key measures for all three topics, including new data on mental health comorbidities among patients treated in the emergency department. Attendees will be able to benchmark their site’s performance on a variety of metrics and come away with ideas for site-level interventions to implement.

After lunch and open networking, the afternoon features 10 concurrent interactive roundtables covering a wide variety of topics. From collaboration across academic and system units, behavioral health, and data reporting topics to a variety of patient-centered initiatives and more, the roundtables offer something for everyone. Attendees will join between two and three 15-minute discussions as they rotate to different roundtable speaker presentations. One of these options includes a longer 30-minute fireside chat with Hari Nathan, MD, PhD, on system-level approaches to quality improvement.

New this year is an innovation station that will be available throughout the day. It will feature a variety of stations where attendees can interact, leave suggestions, and connect with peers. The day will conclude with closing remarks and next steps with Jana Stewart, MS, MPH.

The deadline to register for MVC’s spring collaborative-wide meeting is April 28. We look forward to seeing you there!

 

16 Apr 2025
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State-of-the-State Health Equity Report: A Snapshot of Hospital-Level Priorities, Barriers, and Opportunities in Michigan

State-of-the-State Health Equity Report: A Snapshot of Hospital-Level Priorities, Barriers, and Opportunities in Michigan

April 16, 2025 | 0 Comments | , , , ,

Hospitals across Michigan are increasingly focused on using their available data to assess care delivery gaps, inefficiencies, and areas for improvement. The Michigan Value Collaborative (MVC) developed its 2024 Statewide Health Equity Report to provide a detailed summary of how hospitals across Michigan are approaching this process with a health equity lens. By analyzing MVC claims data along with survey responses from 52 hospitals and 11 health systems, the full report captures how hospitals are leveraging data to evaluate patient care, identify disparities in outcomes, and develop interventions that improve the overall value of care delivery.

Data Collection and Utilization

One of the key highlights of the report was the varied approach and capacity for collecting, measuring, and utilizing data on health equity. Many hospitals utilize readmission rates, clinical quality indicators, and demographic information to identify variations in care. However, the extent to which this data informs hospital-level decisions varies. While some hospitals remain in the early stages of collecting and organizing health equity data, others are beginning to analyze and apply these insights to shape their initiatives. Nearly a third of respondents indicated they were using data to guide funding and program priorities, while a smaller percentage integrated equity metrics into quality improvement strategies.

To further support hospitals in taking action, MVC used its robust medical insurance claims-based data to highlight established disparities for specific service lines. A notable finding was the difference in rates of birth complications by race (Figure 1). Women who identify as Asian and/or Pacific Islander had higher rates of postpartum hemorrhage than other race categories, and patients identified as Black had higher rates of hypertension and severe maternal morbidity (SMM) than the overall population.

Figure 1. Rates of Hypertension, Hemorrhage, and Severe Maternal Morbidity During Index Hospitalization, Overall and by Patient Race/Ethnicity, 2021-2024

Another notable finding was sex differences in cardiac rehabilitation enrollment (Figure 2). Women are significantly less likely to enroll in cardiac rehab within 90 days of discharge for eligible cardiac procedures, take longer to enroll in their first session, and attend fewer sessions on average than male patients. These patterns point to differences in how patients access and engage with follow-up care, and these gaps are present even among hospitals with strong cardiac rehabilitation enrollment rates.

Figure 2. Rates of Cardiac Rehabilitation Utilization within 90 Days of Discharge from a Qualifying Event by Sex, 2015-2023

These MVC claims-based investigations into healthcare outcomes across populations can assist hospitals in setting or enhancing their health equity goals.

Efforts to Improve Healthcare Access

Beyond data collection and analyses, the report summarized a range of efforts to improve healthcare access. Most hospitals have expanded telemedicine services, increased clinic hours, deployed mobile health units, support non-emergency medical transportation programs, and offer rideshare assistance to reach a variety of patient populations who struggle to access care in their community. Language accessibility has also been a focus, with nearly 90% of hospitals offering translated materials and on-site interpretation services. Financial barriers remain a concern, with 79% of hospitals reporting efforts to support patients dealing with medical debt or lacking insurance coverage.

There were also several hospitals implementing community-based programming and solutions in response to gaps for specific disease impacted communities or underserved groups. The most common types of solutions currently supported by hospitals across the state included:

  • Food Security Initiatives: Many hospitals are addressing food insecurity by screening patients for social needs, partnering with community food programs, and even launching hospital-based farms and Healthy Food Rx programs to encourage nutrition-based health interventions.
  • Community Health Workers (CHWs): Increasingly, hospitals are integrating CHWs into their care models to bridge the gap between clinical care and community-based support, particularly in rural and underserved areas.
  • Incorporating Patient Voices: Hospitals are utilizing Community Health Needs Assessments (CHNAs), patient experience surveys, and community advisory boards to ensure that patient perspectives inform quality improvement initiatives.

Looking Ahead

Although most hospitals have taken steps to improve care delivery across all patient populations, they face significant organizational barriers, such as insufficient funding for dedicated staff and programming, lack of staff training or expertise in community-focused challenges, and difficulty communicating the business case or return on investment of such efforts. These barriers and new ones will likely grow in the coming months and years as the field’s federal funding streams shift.

Amid that uncertainty, MVC hopes to play the role of facilitator by supporting hospitals with actionable equity data, facilitating peer learning opportunities through dedicated meetings and sharing of success stories, and financial incentives through the MVC Component of the BCBSM P4P Program. In addition, the MVC Coordinating Center regularly consults with the Michigan Social Health Interventions to Eliminate Disparities (MSHIELD) team on best practices for data collection and equity-centered quality improvement. MVC will demonstrate this commitment via its quarterly MVC member spotlight blog—which will highlight successful initiatives across MVC’s membership—and via dedicated learning sessions at MVC’s Oct. 10 collaborative-wide meeting in Livonia.

If you are interested in pursuing a health equity initiative, MVC has a robust registry of claims data that can be utilized, as well as site specialists who can help facilitate connections with peers doing similar work. Please reach out to us by email if you have a success story to share or want to learn more about related MVC data.

09 Apr 2025
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CQI Spotlight: Michigan Collaborative for Type 2 Diabetes

CQI Spotlight: Michigan Collaborative for Type 2 Diabetes

April 9, 2025 | 0 Comments | , , , ,

Type 2 Diabetes (T2D) affects over 1 in 9 adults in Michigan and increases the risk of kidney and cardiovascular disease, hypertension, nerve and eye damage. Although newer interventions have demonstrated effectiveness in treating and preventing T2D, barriers to equitable, widespread dissemination and implementation remain a challenge. Delivering evidence-based diabetes care to all T2D patients in Michigan is essential for creating a future where diabetes is no longer a chronic progressive disease.

With this vision in mind, the Michigan Collaborative for Type 2 Diabetes (MCT2D) launched in 2021 and aims to accelerate implementation of and eliminate barriers to guideline-concordant care, through supporting its participating practices with quality improvement efforts. MTC2D is currently focused on three evidence-based strategies: dietary and lifestyle changes based on the use of continuous glucose monitors (CGMs), guideline-directed antihyperglycemic medications, and low-carbohydrate eating patterns. MCT2D recognizes the importance of utilizing these strategies to reduce T2D incidence and to slow disease progression to improve health in Michigan and lower health care costs.

In three short years, MCT2D’s quality improvement efforts have already resulted in major achievements. As MCT2D Program Director and Associate Professor of Family Medicine at the University of Michigan Lauren Oshman, MD, MPH, stated,

So far, MCT2D has recruited more than 400 primary care, endocrinology, and nephrology practices across the state. Their efforts have resulted in a 12% relative reduction in patients with an A1c greater than 8% from 2021 to 2023, as well as an increase in CGM prescribing from 17% to 31% for patients who were on insulin (2021-2023).

MCT2D’s recent successes stem from its commitment to placing patients at the heart of their efforts. The MCT2D patient advisory board meets six times a year to guide the activities of the collaborative, including reviewing medication handouts, low-carbohydrate meal plans and grocery lists, instructional videos on injectable medications, and guides for using continuous glucose monitoring devices (Figure 1). This ensures materials are accessible and patient friendly. Patients are also invited to attend collaborative-wide and regional meetings to share their stories alongside healthcare professionals, further emphasizing the central role of the patient in MCT2D’s quality improvement initiatives.

Figure 1.

In addition to supporting patients, MCT2D addresses the needs of clinicians by offering guidance on clinical best practices, as well as insurance coverage and cost-related issues. MCT2D also hosts regional meetings twice a year and monthly educational webinars where guest speakers deliver presentations on topics requested by collaborative members. Sessions have covered topics such as “Mental Health and Diabetes,” “Working with Specialists,” and “Metabolic Surgery for Type 2 Diabetes.”

Achieving health equity is essential in all aspects of healthcare, but it is particularly crucial in the prevention and management of chronic diseases. All of MCT2D’s initiatives aim to advance health equity in communities across Michigan, ensuring that everyone—regardless of race, ethnicity, socio-economic status, insurance coverage, or geographic location—has access to high-quality care for T2D. MCT2D has established six health equity goals aimed at reducing the prevalence and complications of T2D, while enhancing the quality of life for all patients (Figure 2). To achieve these goals, MCT2D has launched several equity-focused initiatives, including a collaboration with Michigan Social Health Interventions to Eliminate Disparities (MSHIELD) to complete one-on-one consultations with practices on their social determinants of health screening processes.

Figure 2.

MCT2D’s impact on the quality of T2D care is dependent on strong collaborative partnerships with its 23 participating physician organizations.  While MCT2D brings together physician participants from primary care, endocrinology, and nephrology, it centers the crucial role of other members of the care team, including pharmacists, nurse practitioners and physician assistants, care managers, nurses, and dietitians. As Dr. Oshman explains, "Taking care of people with T2D is a team sport. The strength of our collaborative comes from our diversity."

Over the past year, MCT2D and MVC have collaborated in several ways. MVC provides claims-based data and analytic consultation to support MCT2D in establishing quality improvement benchmarks. MVC also collaborated with MCT2D in 2024 to develop a statewide report on T2D in Michigan. This report provided a comprehensive overview of the demographics, healthcare visits, and prescription utilization patterns of patients with T2D in Michigan. The report highlighted key trends in healthcare utilization within this patient population, including emergency department visits, hospitalizations, and consultations with primary care providers (PCPs) and specialists.

MVC is currently partnering with MCT2D on a value exercise to compare the use of guideline concordant medications and change in cost and outcomes among T2D patients in MCT2D practices compared to non-participating practices. This work significantly enhanced the MVC team's understanding of pharmacy claims data from BCBSM and BCN and provided valuable insights that will inform future projects and analyses using pharmacy claims data.

MVC is proud to partner with MCT2D in advancing T2D care across Michigan. The BCBSM-funded CQIs play a crucial role in driving healthcare quality improvement, and MVC is excited to continue showcasing the innovative contributions of individual CQIs and the ways in which MVC’s data analytics are supporting high-value care initiatives across the portfolio.

02 Apr 2025
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March Workgroups Highlight Chronic Kidney Disease Detection in Primary Care and Population Health Program

March Workgroups Highlight Chronic Kidney Disease Detection in Primary Care and Population Health Program

April 2, 2025 | 0 Comments | , , , , ,

In March, MVC hosted two virtual workgroup presentations – the first, a rural health workgroup focused on enhancing early detection of chronic kidney disease (CKD) in primary care and the second, a post-discharge follow-up workgroup focused on the impact of launching a population health program. MVC hosts two virtual workgroups per month with topics rotating between post-discharge follow-up, sepsis, cardiac rehabilitation, rural health, preoperative testing, and health in action (ad hoc focused topics). Each month, the MVC Coordinating Center publishes key highlights from the past month’s presentations to provide resources and support best practice sharing across the state.

March Rural Health Workgroup: National Kidney Foundation of Michigan & Michigan Center for Rural Health

In support of National Kidney Month, MVC’s first rural health workgroup of 2025 featured a presentation by Mary Wozniak, Program Manager for the National Kidney Foundation of Michigan (NKFM) and Jill Oesterle, Director of Provider Solutions for Michigan Center for Rural Health (MCRH). The joint presentation focused on the partnership between NKFM and MCRH on a 2024 Medicaid Impact and Expansion grant.

Low recognition of CKD is a chronic health problem. Nearly 35.5 million Americans are projected to have CKD but according to the Centers for Disease Control and Prevention (CDC) up to 90% of patients are unaware of their CKD status. Additionally, among Medicaid beneficiaries with CKD, the average estimated healthcare costs per year is more than six times the average cost per person when compared to patients without CKD.

Despite the availability of diagnostic tests like estimated glomerular filtration rate (eGFR) and albumin: creatinine ratio (ACR), fewer than half of individuals with diabetes and less than 10% with hypertension receive annual CKD screenings, even though both groups face heightened CKD risk. For more information about testing, Wozniak recommended the guidelines for CKD screening and management from KDIGO and KDOQI.

Knowing that CKD can be diagnosed with two simple evidence-based laboratory tests, NKFM and MCRH teamed up to combat low CKD screening rates. To start, Wozniak and Oesterle explained that the partnership established a CKD Learning Collaborative Initiative made up of four rural health clinics: Cass City Family Practice, Cass City Medical Practice, St. Helen Mclaren Primary Care, and Clare McLaren Central. These sites were identified based on data indicating a high CKD prevalence or low CKD screening rates within their Medicaid patient populations.

The collaborative aimed to increase awareness of the importance of early detection and management of CKD among Medicaid eligible populations at Rural Health Clinics (RHCs) using a three-pronged approach:

  1. Increase provider and clinical education
  2. Promote referrals to evidence-based lifestyle change programming (through NKFM)
  3. Provide support and guidance to implement screening into clinical workflows

Each pilot site participated in an initial assessment including the collection of baseline data. NKFM then provided one-hour tailored clinical education sessions on various CKD topics from diagnosis and staging to lifestyle and nutrition approaches for prevention and management. Wozniak and Oesterle attribute the collaborative’s ability to adapt these trainings to each clinic based on their identified needs, capabilities, and goals to the successes observed in increased screening and diagnoses made at these pilot sites when compared to baseline data.

Amongst the four pilot sites, the collaborative found CKD screening rates in patients with diabetes increased on average by 27%, while in patients with hypertension (HTN) screening increased on average by 17% (Figure 1). Overall, CKD diagnosis increased by an average of 6.5% when compared to baseline.

Figure 1. CKD Learning Collaborative Data Findings

Empowering the healthcare team and patients with actionable recommendations was another strategy identified to be especially helpful in moving the needle on screening rates. Ensuring laboratory representation from the beginning of the project was especially helpful in overcoming challenges related to laboratory test ordering and reporting. Moving forward, the presenters note that the project timeline may need to be adjusted to build in enough time to identify clinic champions and develop buy-in with clinic staff.

Throughout the project, NKFM and MCRH met monthly with all the pilot sites together, as well as separately. This allowed them the opportunity to collaborate on shared successes and barriers while also offering an opportunity to cater education and guidance of interventions to each site’s needs. While each pilot site ended the project with different next steps, all will continue to receive support from NKFM and MCRH as they progress on their journeys to diligently increase CKD screening, diagnosis, and referrals to lifestyle management programs.

Using the remaining funds from this grant, NKFM and MCRH built on their successes by developing a CKD toolkit for rural providers. The toolkit allows them to broaden the reach of the CKD Learning Collaborative’s impact to more clinics across Michigan. While the toolkit does cater to a rural health clinic audience, any clinic interested in learning more about enhancing CKD care can access the suite of provider and patient education resources, workflows, and screening tools on MCRH’s website.

Mar. 11, 2025: MVC Rural Health Workgroup

March Post-Discharge Follow-Up Workgroup: Oaklawn Hospital

This month, MVC’s post-discharge follow-up workgroup featured a presentation by Morgan Albright, Director of Case/ Care Management and Population Health at Oaklawn Hospital and Zach Chapman, Executive Director of Oaklawn Medical Group. Their co-presentation centered on Oaklawn Hospital and Oaklawn Medical Group’s collaboration to integrate Medicare Annual Wellness Visits (MAWVs) into their population health program.

MAWVs focus on preventive care and health maintenance and include a health risk assessment, review of medical history, and development of a personalized prevention plan (Figure 2). Unlike a preventive physical exam (IPPE) or routine physical exam, MAWVs do not include a comprehensive physical exam. Albright explained that while MAWVs are a standard benefit for Medicare beneficiaries, these visits were infrequently completed due to the limited time available during a PCP visit. Additionally, since these visits are hands off assessments and previously stand-alone appointments, patient satisfaction following these visits was generally low.

Figure 2. Comparison of Medicare Physical Exam Coverage

In January of 2023, three population health nurses were integrated across Oaklawn’s outpatient offices with the goal of conducting dual and/or phone-prep MAWV appointments. Combining an MAWV with another regularly scheduled visit has helped to alleviate the barriers that existed for the Medicare patient population. Benefits of completing the MAWV include increased care planning, depression screening, and patient satisfaction.

An additional benefit to the integration of the population health nurses and MAWVs has been in the improvement of billing and revenue. Albright explained that while an initial MAWV does not necessarily generate revenue, any subsequent MAWVs, such as those focused on depression screening or social determinants of health (SDoH) concerns, are billable. Champman notes that in 2022, only 66 depression screenings were billed, compared to close to 4,000 in 2024. Similarly, billing for advanced care planning has increased from 94 cases in 2022 to 1,100 in 2024. Chapman estimates the return on investment is about 150% of the cost of a dedicated population health RN. He also noted the impact the introduction of population health support staff has had on reducing the primary care physician’s workload.

In addition to the MAWV assessments, Albright and Chapman note Oaklawn has initiated a chronic care management program. This program is a collaborative effort between Oaklawn’s care managers and a third-party chronic care management vendor. These check-ins take place between regularly scheduled appointments to ensure patients have the resources (access to medications, transportation, etc.) to be successful in management of their chronic conditions. The depth and breadth of the resources available between these two groups allows them to reach out to over 800 patients monthly. Identified downstream effects of this program have been reduced emergency department (ED) utilization and reduced length of stays (LOS).

Paired together, the addition of MAWVs and the chronic care management program have robustly increased Oaklawn Hospital and Medical Group’s ability to reach their aging Medicare patients. Overall, roughly 50% of Oaklawn’s eligible population completed MAWVs in 2024, compared to just 11% in 2021. This translates to about 1,800 wellness visits in 2021 versus 5,500 in 2024. Oaklawn’s next steps include intentionally working to engage with the remaining 50% of eligible Medicare patients to ensure they do not miss out on valuable healthcare resources.

To learn more about Medicare Wellness Visits including coding and billing requirements, visit the Centers for Medicare and Medicaid Services education website.

Mar. 20, 2025: Post-Discharge Follow-Up Workgroup

If you are interested in pursuing a healthcare improvement initiative, MVC has a robust registry of claims data that can be utilized, as well as site specialists who can help facilitate connections with peers doing similar work. Please reach out to us by email if you are interested to learn more about MVC data or engagement offerings. Please also join us for upcoming workgroups by registering on MVC’s website.

26 Mar 2025
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Overcoming Barriers to Healthcare Access: A Success Story at Marshfield Medical Center-Dickinson

Overcoming Barriers to Healthcare Access: A Success Story at Marshfield Medical Center-Dickinson

March 26, 2025 | 0 Comments | , ,

In recent years, the pursuit of high-quality healthcare has pushed an increasing number of organizations to consider how tailored approaches can reduce gaps in outcomes, increase the value of care, and enhance patient experiences with the healthcare system. Reflecting this growing recognition, the Michigan Value Collaborative (MVC) surveyed its members in 2024 to better understand how members were approaching variation in health outcomes across populations. This survey resulted in MVC’s 2024 statewide health equity report [PDF]. With questions focused on data collection, strategic planning, and programming, MVC gleaned a wealth of impactful and innovative solutions already under way in hospitals across the state. To champion and share those stories across the collaborative, MVC will publish quarterly member spotlight blogs that reflect examples of ongoing programs that improve patients’ outcomes and access to care.

For the majority of the surveyed hospitals, the most common focus areas for programming were enhancing access to providers (i.e., telehealth, mobile units, and nontraditional clinic hours), improving access to reliable transportation, offering financial support, and providing translated materials. Although it is common for hospitals to have strategies in place in these areas, the specific approaches are often as varied as the communities they serve.

At Marshfield Medical Center-Dickinson, for example, one way they approach challenges to healthcare access in the community is through dental care programming for low-income patients. Recent studies have established a clear link between oral health and overall health, underscoring the importance of proper dental hygiene as a preventive measure against serious health complications. According to the Mayo Clinic, poor oral health can lead to significant conditions such as endocarditis, cardiovascular disease, pregnancy complications, and pneumonia. Consequently, effective dental hygiene education and preventive care can provide substantial health benefits that extend well beyond oral health alone.

Recognizing the multifaceted benefits of accessible oral healthcare, Marshfield has partnered with Smiles on Wheels to offer monthly dental services—including cleanings, sealants, and fluoride treatments—at their primary care clinic, regardless of the patient's ability to pay. This initiative has been especially beneficial for young children and parents who face financial challenges related to transportation. It also helps families avoid future costs associated with more complex treatments that may result from a lack of preventive care. The program has received positive feedback from the patient population, with many community members expressing their gratitude for the support it provides.

Figure 1. Smiles on Wheels provides dental care services to Marshfield Medical Center-Dickinson patients during wellness care visits.

Photo courtesy of Marshfield Medical Center-Dickinson

Dr. Alexis Cirilli Whaley, MMC-D Pediatrician said, “We are fortunate to have Smiles on Wheels offering dental care to our local children, particularly for those families needing additional support due to economic stressors. The initiative allows for increased access to dental treatment, conveniently scheduled during wellness care visits."

By partnering with Smiles on Wheels, Marshfield Medical Center-Dickinson is leveraging existing resources to create a meaningful impact. This collaboration optimizes the use of available assets and showcases an effective strategy that harnesses the strengths of community partners. Stories like that of Marshfield Medical Center-Dickinson highlight the power of community partnerships in bridging known gaps in care and making a significant difference.

Throughout the coming year, MVC looks forward to showcasing other examples of patient-focused programming that improves the value of care across Michigan’s populations. If your hospital or organization has an initiative they would like to share, please contact the Coordinating Center at Michigan-Value-Collaborative@med.umich.edu – we would love to hear from you.