Healthy Michigan Plan Enrollment Starts Tomorrow

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

Tomorrow is the day we’ve been waiting for and working toward for months. The Healthy Michigan Plan will open for enrollment, bringing a new, affordable health coverage option to hundreds of thousands of Michigan residents.

The collective impact of Michigan’s Health Centers in Health Insurance Marketplace outreach, community education and enrollment assistance has been impressive. But, we’ve got a lot of work ahead to reach and assist this new population of potential enrollees.

When facing a challenge and opportunity as large as the Healthy Michigan Plan it’s sometimes hard to know where to start. So, MPCA has put together a multitude of resources to support and guide the dedicated work of staff, providers, board members and volunteers in organizations statewide.

These new resources are available online at www.mpca.net/oetoolkit and we’ve featured the top ten resources and strategies in a new fact sheet called “10 Things You Can Do to Build Healthy Michigan Plan Awareness.” Can you implement four strategies? How about six? Accomplishing all ten will put your organization well on its way to ensuring your community gets covered!

Stay tuned to MPCA’s website and email networks in addition to this blog for more information, news, updates and progress reports in the days and weeks ahead.

Access to Care Update: A Review of How Nine Michigan Health Care Organizations Are Using Federal Funding to Increase Access to Care Across the State

As reported by MPCA in November 2013, nine health care organizations in Michigan were among 236 organizations nationwide to be awarded funding from the U.S. Department of Health and Human Services to support new Health Center sites. Given a 120-day timeline to complete and operationalize the new Health Centers, staff at those organizations have worked tirelessly to open the doors of the new facilities. Michigan Health Centers are currently health care homes for over 600,000 adults and children at more than 230 sites statewide. These new Health Centers will serve as a source of high-quality, affordable primary and preventive medical, dental, and behavioral health care for an estimated additional 42,210 Michiganders.

Six of the nine Michigan organizations receiving funding are already Health Centers—Cassopolis Family Clinic, Cherry Street Health Services, Covenant Community Care, Health Delivery Inc., Traverse Health Clinic, and Western Wayne Family Health Centers. Three of the nine Michigan organizations are community-based providers of primary and preventive health care but have not received funding under the Health Center Program before: Community Mental Health & Substance Abuse Services of St. Joseph County, Detroit Central City Community Mental Health, and MyCare Health Center in Macomb County. For many residents in these communities, the nearest provider is either miles away or too expensive.

Below is a summary of how each of the nine Michigan organizations is using the funding it was awarded to open a new Health Center to connect their neighbors with the health care they need.

Cassopolis Family Clinic Network was awarded $650,000 in New Access Point funding to help support the medically underserved in Southeast Berrien County by establishing the Niles Community Health Center. The new facility is located at 24 North Saint Joseph Ave. Suite G, in Niles across from Niles Community Hospital. The new site, which opened February 24, is receiving new patients with a projection of serving an additional 3,600 community residents.

Cherry Street Health Services operates a network of more than 20 Health Centers throughout Kent, Montcalm, and Ionia counties. It was awarded $858,333 to operate the Barry Community Health Center, located within the Barry-Eaton District Health Department in Hasting, Michigan. The new site located at 330 W. Woodlawn in Hastings opened on February 3, and is expected to serve an additional 3,700 Barry County residents with primary medical, dental, and behavioral health services.

Community Mental Health & Substance Abuse Services of St. Joseph County was awarded $812,500 to expand services to provide primary and preventive medical care, in addition to the comprehensive behavioral health care and substance abuse services it has provided St. Joseph County residents for more than 30 years. The new full-service Health Center located at 677 E. Main St. in Centreville, opened February 26. Patient navigators and community health works help connect at-risk individuals to needed services.

Covenant Community Care received $650,000 to increase the capacity of its network of Health Centers, which includes a school-based Health Center and a mobile community-based dental program, by opening an additional site in west Detroit. In collaboration with Joy-Southfield Community Development Corporation (JSCDC), Covenant Community Care opened its sixth Health Center at the current location of JSCDC’s free clinic at 18917 Joy Road in Detroit on February 17. An estimated 7,500 additional primary medical, dental, and behavioral health care visits from residents in the west-side of Detroit is expected in the first year at the new Health Center site.

Detroit Central City Community Mental Health received $793,500 in funding to expand its services to include primary and preventive health care to meet the complex needs of Mid-town Detroit. Having provided comprehensive behavioral health care services for more than 40 years, Detroit Central City Health Center will be able to serve an additional 3,500 local residents. The new integrated Health Center provides primary medical, dental, and behavioral health care for all ages, including complete health care for the entire family such as health screenings, well-child visits, OB/GYN, pediatric and adolescent medicine, internal and geriatric medicine, HIV/AIDS care, physicals, care for chronic conditions such as diabetes, asthma, and high blood pressure. Detroit Central City Health Center opened the first week of March. Its location at 3427 Woodward Ave. in Mid-town Detroit provides easy access to bus routes.

Health Delivery, Inc. (HDI), a Saginaw-based Federally Qualified Health Center network that has operated Health Centers throughout Mid-Michigan for the past 40 years, was awarded $858,333 in new funding to open the first two Health Center sites in the Huron County Thumb Area of Michigan. The Thumb Area Community Health Center, located at 1080 S. Van Dyke Rd. in Bad Axe on the Huron Medical Center campus, opened its doors on February 24. HDI’s Behavioral Health Primary Care Center, located at 1108 S Van Dyke Rd. also in Bad Axe, opened on March 3. Additionally, a portion of the funding was used to expand dental services and extend hours at HDI’s sites in Shiawassee County.

MyCare Health Center, a collaboration of safety net providers to meet the primary health care needs of the most vulnerable residents of Macomb County, received $866,667 in funding to support five Health Center sites. MyCare Health Center will serve approximately 4,000 additional Macomb County residents sites in Center Line, Mount Clemens, Clinton Township (2), and Madison Heights. Through a network of referral providers, MyCare Health Center will enhance the primary care services it offers onsite to increase access to obstetrics/gynecology, oral health, and behavioral health services. Additionally, two MyCare sites have fully integrated behavioral health and primary care services.

Traverse Health Clinic, a major community-based provider serving Traverse City and surrounding areas, has provided access to health care services since the mid-1970s. Originally a free clinic, the organization was certified by the Centers for Medicare and Medicaid Services as a Federally Qualified Health Center (FQHC) Look-Alike in fall of 2013. Soon after, Traverse Health Clinic received $866,667 in funding from the Health Resources and Services Administration to transition to a Health Center Program grantee. The additional funding will enable Traverse Health Clinic to care for increased numbers of people, providing comprehensive primary and preventive medical, dental, and behavioral health care services at its facility located at 3155 Logan Valley Rd. in Traverse City, Michigan.

Western Wayne Family Health Centers (WWFHC) was awarded $145,070 to open its third Health Center site on March 5. Serving Lincoln Park, River Rouge, Ecorse, and the surrounding areas, WWFHC’s new Health Center will serve an additional 5,550 patients by providing much needed access to primary medical, dental, and behavioral health care, as well as pharmacy services. It is located at 25650 W. Outer Dr. in Lincoln Park.

MPCA applauds the hard work of these organizations in finalizing and executing their respective projects in the midst of the most transformative time in health care policy in recent history. We look forward to many years of collaborating with each of the organizations to continue the mission of promoting, supporting, and developing comprehensive, accessible, and affordable community-based health care services for everyone in Michigan.

As the End of Open Enrollment Nears, Michigan Health Centers Continue as Sources of Information and Assistance

With the end of open enrollment in the Health Insurance Marketplace only 18 days away, the interest in getting signed up by March 31st for health insurance coverage has skyrocketed. People across Michigan are requesting assistance from Certified Application Counselors and Navigators to complete their applications for Qualified Health Plans. Health Centers play a chief role in providing this enrollment support. They are continuing to host events and partner with community organizations to share accurate and helpful information to people needing health coverage.

Family Medical Center of Michigan hosted three Affordable Care Act sign-up events in the first half of March, assisting over 100 people at their event in Lenawee County. Read more

Advantage Health Centers hosted an Obamacare Education and Enrollment Event in Detroit along with Affirmations, MichUHCAN, and Jamison & Green Associates as a part of a larger effort to encourage the LGBT community to enroll. Read more

Hamilton Community Health Network’s Navigators and Certified Application Counselors are educating Genesee County area residents about their options for health care coverage. Read more

Cherry Street Health Services partnered with the Grand Rapids Public Library to host an Affordable Care Act Enrollment Session, where Health Center Certified Application Counselors answered questions and helped people enroll – read more. Cherry Street Health Services is also hosting an event on March 20 at the Flat River Community Library in Greenville to educate, answer questions, and help community members enroll in health insurance. Read more

In the latest release of enrollment numbers, U.S. Health and Human Services (HHS) reported that Michigan had the 8th highest percent of eligible individuals enrolled in Marketplace plans. This is up from the 10th highest, as reported for January. Check out MPCA’s blog article explaining these numbers. For information and assistance in getting enrolled in an affordable health care plan, your local Health Center has the resources to help you! You can locate a Health Center near you here.

February Enrollment Progress

Yesterday, the U.S. Department of Health and Human Services’ Assistant Secretary for Planning and Evaluation provided an updated look at enrollment in the Health Insurance Marketplace.

The new report, which provides enrollment data through March 1, 2014, offers an in-depth look at enrollee demographics, plan selection patterns, and information on Marketplace financial assistance, in addition to Medicaid/CHIP eligibility assessments.

The most recent indicators for the State of Michigan are:

  • 144,587 Michigan residents have selected a plan in the Marketplace
    • Michigan’s enrollment total exceeded HHS projections for the state by nearly 16,000 enrollees
    • 28,013 residents have also selected a stand-alone dental plan
  • 19.9% of the eligible population in Michigan has enrolled
    • Michigan currently has the 8th highest percentage of eligible residents enrolled, improving from 10th highest (15.5%) at the end of January
  • Gaps remain between them number of individuals who applied and were eligible to enroll and those who actually selected a plan
    • 313,644 Michigan residents were found eligible to enroll in a Marketplace plan; 187,057 were found eligible to enroll with financial assistance. Since 144,587 actually selected a plan, we still have work to do in assisting and encouraging applicants to complete their enrollment.
  • The percentage of young adults (age 18-34) enrolling through the Marketplace in Michigan held steady at 26%
    • Michigan’s young adult enrollment is slightly higher than the average for all states (25%) but lower than we would hope as over one-third of premium tax credit eligible individuals in Michigan fall into this age group
  • 87% of Michigan’s enrollees selected a Silver medal level plan or higher
    • This is higher than the average for all states (80%) and a good indicator of positive plan selection decisions
  • 87% of Michigan’s enrollees received financial assistance through the Marketplace
    • 80% of those who received financial assistance selected a silver plan, which shows most enrollees are maximizing the potential impact of cost-sharing reductions
  • 40,347 Michiganders were assessed eligible for current Medicaid or CHIP coverage
    • This number remains low but will climb dramatically when the Healthy Michigan Plan is implemented

We’ll continue to analyze enrollment trends as the first Marketplace open enrollment period comes to a close and we begin enrolling Michiganders in the Healthy Michigan Plan in the weeks to come.

Happy 34th Birthday to Us!

Michigan Primary Care Association (MPCA) is celebrating its 34th birthday today, February 28, 2014. It was on this date back in 1980 that MPCA incorporated to expand the scope of what was then the Michigan Association of Rural Health Care (MARHC).

MARHC was established in 1978 to help meet health care needs of the state’s rural communities by developing a network of rural health care providers and advocate organizations. Within the first two years it became clear that great need existed outside of rural communities, as well. To help meet that need, the Association broadened its work to support initiatives in urban, migrant, homeless, as well rural underserved communities across the state.

Fast forward 34 years, today MPCA is the voice for 39 Health Center organizations, which serve more than 600,000 Michiganders at over 230 health care delivery sites, and other community-based providers.

“Just as the health care system has undergone tremendous transformations over the past 34 years, so has MPCA,” said Kim Sibilsky, MPCA’s CEO. “Our mission of promoting, supporting, and developing comprehensive, accessible, and affordable community-based health care services to everyone in Michigan remains the same, however. It is our vision, and the guiding force in all we do, that every Michigander has convenient, affordable access to quality health care.”

The board and staff at MPCA is honored to continue this mission to help build a healthier Michigan and country by supporting and partnering with Michigan Health Centers, as well as the diverse public, private, and nonprofit organizations with which we collaborate at the local, state, and national levels. Happy birthday, MPCA!

You can learn more about the history of MPCA and Michigan Health Centers at www.mpca.net/history.

Advocates at MPCA’s Legislative Forum Increase Awareness of Health Centers, Policy Issues Impacting Access to Care

Board and staff members from Michigan Health Centers convened in Lansing on Wednesday, February 26 to attend the 2014 MPCA Legislative Forum. This annual event is an opportunity for Michigan Health Center board and staff members to get the latest updates on the current legislative climate and its impact on Health Centers and access to care in Michigan. It is also an opportunity to meet with State Legislators who represent the districts where Health Centers serve as health care homes for the Legislators’ constituents.

Attendees of this year’s Forum participated in over 70 meetings with State Senators and Representatives in their offices. More informal discussions also took place during a legislative luncheon. In addition to increasing awareness of the services that Health Centers provide in communities across the state, board and staff members asked for the Legislators’ support of MPCA’s 2014 policy priorities—enhancing the state’s primary care workforce policies and promoting behavioral health access and integration.

MPCA was honored that Senator John Moolenaar and Representative Matt Lori, chairs of the Community Health Appropriations Subcommittee in their respective chambers; and Senator Jim Marleau and Representative Gail Haines, chairs of the Health Policy Committee in their respective chambers, were able to join the morning general session to share updates on the 2014 state legislative budget and health policy issues and priorities.

We were also honored that Michigan Department of Community Health Director James Haveman joined us to give an update on the work that is being done to implement the Healthy Michigan Plan.

“As we continue to make progress on the Healthy Michigan Plan implementation, it is important that we recognize the important contributions made by the Health Centers in Michigan, as well as the Michigan Primary Care Association,” said Director Haveman. “Thanks to the efforts of our partners across Michigan, nearly half a million Michiganders will have access to health care that will help them take charge of their health, become healthier Michiganders, and in turn, help contribute to the comeback of Michigan. Our work does not stop here, however. Michigan Health Centers and MPCA will be integral to finding, and enrolling eligible residents into the Healthy Michigan Plan in the coming months. We’ve already accomplished so much together, and I look forward to our continued partnership.”

You can watch a recording of Director Haveman’s address below.


During the Fourm, MPCA presented Senator Randy Richardville (R-Monroe) and Representative Mike Shirkey (R-Clark Lake) with the Champion for the Medically Underserved Award for their leadership in ensuring more Michigan residents have insurance coverage through the bi-partisan Healthy Michigan Plan.

“Health Centers were established nearly 50 years ago to ensure access to care for all, regardless of insurance status or income level. The historic passage and implementation of the Healthy Michigan Plan is a monumental step toward achieving that mission, and this award is a token of our appreciation on behalf of thousands of Michigan residents,” said Kim Sibilsky, MPCA’s Chief Executive Officer.

Pictures from the 2014 MPCA Legislative Forum are posted in a photo album on the MPCA Facebook page.

“Thank you for a great day with our legislators. It was very informative and encouraging—encouraging because our legislators recognize and support Health Centers, us. Also, chatting with other Michigan Health Center administrators, providers, and board members makes me feel proud and privileged to be a part of this movement,” said Ted Hilleary, Board Chair, Center for Family Health.

Insights into Low-Income Americans’ Experience with Coverage and Care

The Kaiser Family Foundation recently released an in-depth report that offers insight into the attitudes and health care experiences of adults at the start of Affordable Care Act (ACA) implementation and points us in the right directions for outreach and enrollment going forward. The Uninsured at the Starting Line: Findings from the 2013 Kaiser Survey of Low-Income Americans and the ACA took information from comprehensive surveys of people with low and moderate incomes, asking questions about health coverage, current patterns of care, and family situations. What people shared about their experiences with health insurance, how they access health care, and the obstacles they face is informative as we understand the challenges of open enrollment and adapt to meet people’s needs.

Access to Coverage
In addition to painting a picture of the lack of access to affordable health care coverage, the report reveals that most uninsured adults have been without coverage for 5 years or more. Adults with health insurance tend to have continuous coverage over time, but many have disruptions or changes to their plans, mostly due to changes in employment status employment. The numbers are sizable: 18 million adults lose or gain coverage during the year, and 17 million have changes in their insurance plan.

There has been a monumental effort during open enrollment to educate consumers about their new coverage options under the ACA and assist them in enrolling in plans. These report findings demonstrate that there will be a need for outreach and enrollment assistance that goes beyond helping consumers access care for the first time and provides continuous support to enroll and keep people in coverage, as well.

Choosing a Health Plan
The surveys found that people did not always prioritize the lowest cost when picking a health insurance plan. Thirty-two percent of people surveyed reported choosing a plan because of the benefits that were offered, 29% because the cost would be low, and 22% because of provider networks.

Internet access is an important tool for enrolling in a plan and maintaining coverage under the ACA. While most uninsured adults have access to the Internet, 19% of those qualifying for Medicaid (<138% FPL) and 14% of those eligible for the premium tax credit (139-400% FPL) reported that they did not have Internet access readily available. In addition, a regular monthly premium must be paid to maintain coverage, and 23% of uninsured adults (100-400% FPL) indicated that they did not have checking or savings accounts.

Certified Application Counselors and Navigators play a central role in helping consumers choose a health insurance plan. The task of filtering and explaining options in Healthcare.gov must consider the various priorities that people balance in plan selection and point consumers to resources that provide additional plan information. Consumers also rely on assisters to help them overcome logistical obstacles to access and payment.

Getting Care
Most people without insurance have little connection to the health care system. More than 41% of uninsured adults reported no health care visits in the last year, as compared to 10% of Medicaid beneficiaries and 13% of adults with employer coverage. A substantial number has health needs, many of which are unmet or met with difficulty due to cost.

Outreach may be needed to help those enrolling in plans for the first time to find a regular provider and establish a pattern of regular preventive care. Those who rely on care at an emergency room or urgent care center may need guidance in navigating the primary care system. Health Centers will play a critical role in ensuring access to primary and preventive care for those newly enrolled in coverage through the Marketplace, or the Healthy Michigan plan when it is available beginning in spring 2014. You can read more about the role of Health Centers here.

Data Tables
For a better understanding of uninsured adults and their patterns of coverage, you can link to data tables in the report:

Table A1: Demographics of Adults, by Insurance Coverage

Table A2: History of Uninsurance and Attempts to Gain Coverage Among Currently Uninsured Adults, by Income

Table A4: Reasons for and Problems with Choosing Health Plan, Among Adults who Had and Made a Choice, by Income

Table A6: Knowledge of Coverage Pathways available under the ACA, by Income and Coverage

If you have any questions about this article, please contact Julie Tatko, MPCA Program Coordinator, Outreach, Education & Enrollment.