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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

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.

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MVC Welcomes Its Newest Senior Analyst, Steven Ellinger

MVC Welcomes Its Newest Senior Analyst, Steven Ellinger

I’m ecstatic to join the MVC team as a senior analyst and bring my passion for healthcare analytics to the table! I am joining the team with over a decade of experience in healthcare analytics, pricing adjudication, reimbursement analysis, and provider network management. I’ve spearheaded projects to optimize network-level claims reporting and streamline data processes in every role. My background in economics and finance from Western Michigan University has helped me develop a strong analytical mindset, which I’ve applied in roles at Michigan Medicine-Sparrow, IBM Watson Health, McLaren Health Plan, and beyond. Healthcare large data manipulation is a passion of mine and you’ll see me smile each time a question is asked, as I am eager to find the answer.

Prior to joining the MVC team, I enjoyed five years as a pricing analyst at University of Michigan Health Plan (formerly Physicians Health Plan). I was responsible for establishing and maintaining provider fee schedules, ensuring competitive and compliant compensation across a vast provider and facility network. My expertise in SQL, Microsoft Excel, claims processing, and financial reporting have been instrumental in automating adjudication processes and enhancing financial forecasting. I also worked closely with provider relations, contract negotiations, and system configuration, making data-driven decisions to enhance efficiency.

Outside of work, my two kids under five keep me very busy with not a lot of free time. When I do find that time, I love staying active—backpacking, running marathons, and formerly teaching swing dancing. You will find me every year at the Indycar Detroit Grand Prix, at the paddock, pit line, or at the box suites, wishing the race was back at Belle Isle. I am thrilled to be on board and look forward to working with MVC’s members to make an impact on healthcare.

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MVC Coordinating Center Looking Back at 2021 and Forward to 2022

Let me begin the first MVC blog of 2022 by wishing you all a very happy new year on behalf of everyone at the MVC Coordinating Center. I’ve started my last two recaps with this line and ended with the hope of seeing you all in-person sometime soon. Since we still haven’t quite managed to get together in-person yet, I’d like to reiterate our thanks and gratitude to each of our collaborative members and those hospitals and physician organizations across the country who have continued to work tirelessly against the ongoing pandemic.

The MVC team has remained remote throughout 2021 and not only have we mastered the Zoom mute button, but we’ve continued to provide support to help MVC’s 100 hospital members and 40 physician organizations during this time.  In 2021, the MVC team held two virtual collaborative wide meetings, conducted 62 tailored registry webinars, undertook 58 virtual site visits, delivered 56 custom analytic requests, facilitated 34 workgroups, disseminated 21 push reports, and held five virtual regional networking events. As a result of this activity, the collaborative has welcomed 13 new hospital members to the collaborative.

In addition to these efforts, the MVC Coordinating Center has continued to adhere to our commitment to provide hospitals and POs with increased access to meaningful benchmarked performance data. In May of this year, MVC’s data portfolio grew with the addition of Michigan Medicaid data, and this was recently refreshed in early October. The data range for this data source currently covers 1/1/2015 – 9/30/2020, reflecting index admissions from 1/1/2015 – 6/30/2020. MVC Medicaid claims (Fee-for-Service and Managed Care) account for a total of 319,140 episodes (19.4% of all MVC episodes) and cover 256,889 beneficiaries. Overall, MVC data sources now comprise over 80% of Michigan’s insured population.

We look forward to continuing this growth in 2022 as we strive to improve the health of Michigan through sustainable high-value healthcare. There are a number of new developments in the pipeline for the coming year and I excited to be able to share some of these with you.

New Hospital Push Reports

A number of new reports will be added to MVC’s suite of reporting in 2022, focusing on topics such as COVID-19, Pneumonia, and Health Equity. The Coordinating Center will work closely with members, the wider CQI community, and other stakeholders to ensure the introduction of other new and novel approaches to sharing our data.

New Physician Organization Reporting

Driven by continued communication with members, the Coordinating Center disseminated its first PO-specific report focused on joint replacement towards the end of last year and has identified two new conditions of interest for future development (gastroenterology and hysterectomy). The Coordinating Center will also be working closely with PO members to inform the development of new metrics for the MVC online registry.

Increased Custom Analytics

Over the last year, the MVC team has devoted effort to raising awareness of MVC’s custom analytic offering to members. This has proved successful, with 56 custom projects undertaken for members in 2021 alone. This support will continue into 2022 – if you are interested in learning more, please contact the MVC Coordinating Center (michiganvaluecollaborative@gmail.com).

Emphasizing Equity in Healthcare

Most measures of overall health are worse in the US compared to any other developed country. The state of Michigan in particular ranks poorly in measures of population health, including tobacco use and the inter-related issues of inactivity, poor nutrition, and obesity. The relationship between these poor health behaviors and social determinants of health are closely interlinked and represent a huge opportunity to improve health and healthcare outcomes for targeted patients. In the coming year, MVC will be exploring how best to use its data and engagement platforms to emphasize equity in healthcare.

Collaborative Wide Meetings

The MVC team will continue to hold two flagship semi-annual collaborative wide meetings. These will take place on Friday, May 13th and on Friday, October 28th. The MVC team will also be holding five regional networking events throughout the year and plans to pilot a new ‘Northern Meeting’ in Summer 2022. More details to come.

New MVC Workgroups

The Coordinating Center’s suite of peer-to-peer virtual workgroups will continue to provide a highly accessible online platform for hospital and PO leaders to come together, collaborate, and share practices. In addition to MVC’s Chronic Disease Management, Sepsis, Joint, and Diabetes workgroups, two new groups will be added in 2022. This includes forums focused on ‘Health Equity’ and ‘Health in Action’.

As these activities and other planned developments come to fruition, we will be sure to share updates with you through our various engagement platforms. If you have any questions in the meantime, please do not hesitate to contact the MVC Coordinating Center at michiganvaluecollaborative@gmail.com. Happy New Year, and we look forward to a great 2022 together.

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Fall Semi-Annual Meeting Agenda Highlights Health Equity Topics

Fall Semi-Annual Meeting Agenda Highlights Health Equity Topics

The MVC Coordinating Center recently released the full agenda for its forthcoming fall Semi-Annual Meeting on Friday, October 22, 2021, from 10:00-11:30 am. The MVC Coordinating Center holds collaborative-wide meetings twice each year to bring together quality leaders and clinicians from across the state. This year’s theme of “the social risk and health equity dilemma” is reflective of a growing priority within the healthcare system generally, as well as newer activities within the MVC Coordinating Center.

Speakers at semi-annual events are often members who share their stories of success, challenges, barriers, and solutions in pursuing a higher value and quality of care. The speakers outlined on October’s agenda showcase the breadth and depth of knowledge that exists within the collaborative in the health equity space. They also represent a variety of stakeholder groups, including hospitals, physician organizations (POs), Collaborative Quality Improvement (CQIs) programs, and of course MVC Coordinating Center leadership.

The first guest speaker will be Carol Gray, Program Manager of the new Michigan Social Health Interventions to Eliminate Disparities (MSHIELD) CQI. She leads the overall management, performance, and coordination of the MSHIELD program and Coordinating Center team. She has extensive experience managing public health research teams, communicating across and coordinating with multiple partnerships, and linking and engaging with community-based organizations in Detroit and academic faculty at the University of Michigan. Her presentation on, “Aligning Partnerships to Achieve Health Equity,” will speak to that expertise.

The meeting also features the expertise of Dr. Nicole J. Franklin, Assistant Medical Director at the McLaren Bariatric and Metabolic Institute. She provides psychological support to bariatric patients before and after weight loss surgery. In addition, Dr. Franklin is the chair of the Diversity and Inclusion Committee at McLaren Flint and has co-facilitated the Diversity Committee within all three local hospitals’ psychology training programs for the last 10 years. She is an Air Force veteran and a graduate of Wright State University’s School of Professional Psychology. Referencing her work within the greater Flint community, her session will address, “The Health Gap: An Exploration of how one hospital is working to bridge the gaps between health care and social care.”

Another perspective will be brought by Leah Corneail, Director of Utilization and Population Health at the Integrated Healthcare Association (IHA). In this role, she is responsible for leading utilization and cost improvement efforts, ensuring success in risk-based contracts and CMS demonstration programs, and collaborating with community partners to improve population health. Corneail has several years of experience in population health and health policy. Prior to joining IHA, she served as a Senior Project Manager in the Michigan Medicine Population Health Office, where she managed Michigan Medicine’s portfolio of value-based payment models and partnered with operations to implement care transformation initiatives. Leah received her Master of Public Health degree from The George Washington University’s Milken Institute School of Public Health. She will speak to, “IHA Efforts to Screen and Address Patient Social Influencers of Health (SIOH).”

Also representing the approach of a PO will be Melissa Gary, Community Liaison with the Great Lakes Physician Organization (GLPO). In this role, Melissa is responsible for bridging the gap between healthcare providers of GLPO and the local community agencies to better align the mission of GLPO. Utilizing her several years of experience in healthcare and nonprofit organizations, she has built the GLPO social determinants of health process. She is a passionate community servant with the ability to motivate and inspire individuals to identify their own potential and shares in the passion to serve others. Melissa is a graduate from Ferris State University where she studied nuclear medicine and healthcare administration. She has minors in science, biology, pre-pharmacy and paralegal.

Attendees can also expect to hear from MVC Coordinating Center leadership and staff about MVC’s Medicaid data, the MVC Component of the Blue Cross Blue Shield of Michigan (BCBSM) Pay-for-Performance (P4P) Program, and general program updates.

These presentations could be informative and useful for any of the following stakeholders who are welcome to attend:

  • MVC Hospital Site Coordinators and Champions
  • MVC Physician Organization Site Coordinators
  • Quality Leadership
  • Clinicians
  • Managers and front-line staff in the following clinical areas:
    • Population health
    • Chronic disease management
    • Post-acute care
    • Value-based care
    • Care coordination
    • Discharge planning
    • Social work
    • Others whose work addresses health equity or social risk factors

In addition, hospitals that have attended both of MVC's 2021 Semi-Annual Events (May 2021 and October 2021) will be eligible for one additional bonus point toward Program Year 2021 of the MVC Component of the BCBSM P4P Program.

Those interested in attending this informative and collaborative meeting should register here. The MVC Coordinating Center looks forward to a fantastic meeting. See you there!

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Long COVID-19, Just One Aftereffect of COVID-19

With continued COVID-19 surges occurring worldwide despite the availability of a number of variations of vaccines, some patients continue to experience what is now being dubbed as “Long COVID-19” or “Post COVID-19 Syndrome”. Symptoms that are commonly experienced include a persistent cough, dyspnea, chest and/or joint pain, neuralgia, and headaches. These symptoms can last up to 12 weeks and in some cases, even longer. The more people that develop long COVID-19, the greater the strain on the healthcare system and need for appropriate diagnosis and treatment options.

A recent paper by A.V. Raveendran from January 2021 proposed diagnostic criteria to help confirm a diagnosis of long COVID-19. Depending on clinical symptomology, duration criteria and the presence or absence of a positive swab or antibodies, a long COVID-19 diagnosis can be categorized as confirmed, probable, possible or doubtful. Having an appropriate diagnosis will allow the practitioner to prescribe the relevant treatment plan.

In the United Kingdom, where the number of people exhibiting long COVID-19 continues to increase, a guideline has been developed by the National Institute for Health and Care Excellence to provide recommendations to help identify, assess, and manage the effects. As more evidence is collected, the plan is to update the document on a continuous basis to maintain its validity. The guideline takes into consideration clinical symptomology, duration criteria, and the presence or absence of a positive SARS-Cov-2 test. It also provides guidelines for suggested referrals, and a plan of care with follow-up and monitoring.

While the guideline manual has many useful suggestions, there are a number of gaps where further detailed information will be needed.  As new information is discovered, the goal is to include comprehensive reviews of symptomology, and pathology of the disease process and a better understanding of the variation in impact. Simultaneously, there needs to be an increase in rehabilitation and community resources to allow for individualized evidenced based care for those suffering from the debilitating effects of long COVID-19.

The Michigan Value Collaborative continues to assess data related to COVID-19 and will be sharing a dedicated COVID-19 push report with members in the coming months. If you would like access to the MVC registry, please request it here or via email michiganvaluecollaborative@gmail.com