Category Archives: Health Data

Understanding ACA Enrollment Data

By Phillip Bergquist, Director of Health Center Operations, Michigan Primary Care Association

Sarah Kliff said it best in her post for the Washington Post’s Wonkblog— “counting the number of people who have signed up for Obamacare turns out to be vexingly difficult. After four months of open enrollment, now seems like an excellent time to break down what we do and don’t know about the exact number of people gaining coverage through the Affordable Care Act.”

Kliff’s post refers extensively to the monthly updates on health insurance enrollment published by the U.S. Department of Health and Human Services’ Assistant Secretary for Planning and Evaluation. The reports provide enrollee demographics, intel on plan selection and information on Marketplace financial assistance, in addition to Medicaid/CHIP eligibility assessments.

Building on Wonkblog’s analysis of national enrollment data, I wanted to share some of the most recent indicators for the the State of Michigan infused with a little editorial context.

  • 112,013 Michigan residents have selected a plan in the Marketplace.
    • Michigan’s enrollment total exceeded HHS projections for the state by just over 12,000 enrollees. However, we still have a lot of work ahead to reach the 161,000 enrollee target set for the end of March.
  • 15.5% of the eligible population in Michigan has enrolled.
    • Michigan has the tenth highest percentage in the country and the second highest amongst states using Healthcare.gov.
  • There are still significant gaps between them number of individuals who applied and were eligible to enroll and those who actually selected a plan.
    • 255,055 Michigan residents were found eligible to enroll in a Marketplace plan; 147,654 were found eligible to enroll with financial assistance. Since 112,013 actually selected a plan, there appears to be a need for stronger follow-up on applications to capture those who submitted but haven’t yet enrolled.
  • The percentage of young adults (age 18-34) enrolling through the Marketplace in Michigan increased slightly from 25% cumulatively in January to 26% in February.
    • Michigan’s young adult enrollment is slightly higher than the average for all states (24%) but lower than we would hope as over one-third of premium tax credit eligible individuals in Michigan fall into this age group.
  • 88% of Michigan’s enrollees selected a Silver medal level plan or higher.
    • This is again higher than the average for all states (81%) and a good indicator of positive plan selection decisions. Consumers appear to be choosing higher value plans over those that are simply cheapest.
  • 86% of Michigan’s enrollees received financial assistance through the Marketplace.
    • Nearly 80% of those who received financial assistance selected a silver plan, which shows most enrollees are maximizing the potential impact of cost-sharing reductions.
  • 34,032 Michiganders were assessed eligible for current Medicaid or CHIP coverage.
    • Admittedly, this number is very low right now. It will climb dramatically when the Healthy Michigan Plan is implemented later this spring.

With only 41 days left in the Marketplace open enrollment period, we won’t have to wait long to see how the amazing outreach and education efforts  in communities across the state impact coverage enrollment. We’ll be sure to continue to dig into the enrollment data to better understand our collective impact in the months to come.

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Michigan Health Centers in Solid Footing for Provider Recruitment in 2014

NHSCNURSE Corps

With attention surrounding access to care often focusing on provider recruitment efforts, it can be easy to overlook the many levels of work that bolster those efforts in numerous ways. One such effort is the federal Health Professional Shortage Designation (HPSA) process, administered by the Health Resources and Services Administration (HRSA). This involves a closely integrated partnership among Michigan Health Centers, Michigan Primary Care Association, the Michigan Department of Community Health, and HRSA.

Working fervently up to the end of the calendar year to lock in federal Automatic-Facility HPSA designation scores, HRSA re-scored nine Michigan Health Centers from all regions of the state in the final weeks of 2013. The Automatic-Facility HPSA score is calculated by taking many factors into consideration, and while they vary slightly across the health disciplines, each use the common criteria of population-to-provider ratio, percent of population with incomes below 100% of the federal poverty level, and the travel time or distance to the nearest source of care. For primary care, the additional criteria used for determination is infant mortality or low birth weight rate. For dental care, the additional criteria is the percent of population with access to fluoridated water, and for mental care, the additional criteria used in determination of score is the youth or elderly ratio, as well as substance abuse and alcohol abuse prevalence.

The re-scoring process resulted in positive increases for each of the organizations. Having a federal Automatic-Facility HPSA designation allows a Health Center to apply for approval to have one or more delivery sites participate in student loan repayment programs through the National Health Service Corps (NHSC) and/or NURSE Corps sponsored by HRSA.

For these nine Michigan Health Centers, the average score increases for primary, dental, and mental health care were 7, 9, and 4, respectively. These increased scores mean increased competitiveness for NHSC and NURSE Corps site approval. Along the same lines, six of the nine Michigan Health Centers are considered in Tier 1 ( a score of 14 or higher) for placement in the dental and mental health disciplines, making them eligible for the max contribution level for the NHSC and NURSE Corps loan repayment program for practitioners committing to two years of service.

Additionally, eight of the nine Health Centers saw a score increase of five or greater in primary care. For dental care, five of the nine received score increases of greater than 10, while two other Health Centers received a five-point score increase. In the mental health discipline, despite overall slighter score increases, two Health Centers received increases greater than five, while the remaining Health Centers saw increases ranging from one to four points.

With the National Health Service Corps and NURSE Corps loan repayment program application cycles now open for Fiscal Year 2014, news of the score increases comes at a perfect time. The NHSC application cycle is open through March 20, and the NURSE Corp application cycle through February 27.

For more information on the National Health Service Corp, please click here. For more information on the NURSE Corps, please click here.

Kids Count: More Children Have Health Insurance, Families Still Struggling

By Natasha Robinson, MPCA Communications Specialist

More of Michigan’s children are living in poverty and families are still struggling to cover the basics, according to the latest Kids Count in Michigan Data Book.

The good news is that data did show some improvement in the state for children’s health insurance and infant mortality. More than 95 percent of children in Michigan have health insurance, one of the highest rates in the country. Nationally, an average of 8 percent of children are uninsured. Additionally, mortality rates for infants fell by 8 percent between 2005 and 2010 while the death rate for children/youth ages 1-19 declined 11 percent.

“Kids Count Data show that Michigan has more work to do to provide better economic security, health, and educational opportunities. MPCA and the 35 Health Center organizations we represent have worked diligently to make sure children in Michigan have health coverage and access to care, and we are glad to see data show more children are insured now than in the past,” said Kim Sibilsky, MPCA’s executive director. “Health Centers across the state offer medical, dental, and behavioral health care services, and their doors are open to all. Fully implementing the Affordable Care Act as it was intended will give more children and families a chance to thrive in Michigan.”

kids count 2012 graphicKids Count Data also shows that the health outcomes of minority children are disproportionate to white children. For instance, black children insured by Medicaid have the highest rates of asthma and of asthma-related emergency department visits compared with other children enrolled in Medicaid, according to the 2012 Kids Count Data Book. “These dramatic differences suggest these children are not able to get the necessary preventive care or to avoid the environmental triggers,” the Data Book says. “Even more troubling, the prevalence of asthma and emergency room visits is increasing among such children.”

Ottawa, Livingston and Clinton counties were ranked the best for overall child wellbeing while Clare, Roscommon and Lake counties were the last among the 82 counties ranked. Keweenaw County was not included in the rankings because it lacked data for most indicators.

Recommendations outlined for improving the health of Michigan’s children included to advocate for policies that improve the health and well-being of children in low-income communities and communities of color, address the causes of the high teen homicide rates in black communities, and support the successful implementation of the Affordable Care Act.

“In order to help struggling families, state policymakers should restore the Michigan EITC [Earned Income Tax Credit], expand Medicaid as required under the Affordable Care Act, restore unemployment benefits, and look for ways to help families meet their basic needs,” Gilda Z. Jacobs, president & CEO of the Michigan League for Public Policy, said in a statement. “Although a recovery is under way, it has not been felt by all families. In fact, a third of working families in Michigan are low income and struggle to cover the basics — housing, food and utilities.”

The annual Data Book is released by the Kids Count in Michigan project. It is a collaboration between the Michigan League for Public Policy and Michigan’s Children. Both are nonpartisan, nonprofit advocacy organizations concerned about the well-being of children and their families.