Health Care Innovation Awards Round Two: Michigan

Notes and Disclaimers:

• Projects shown may also be operating in other states (see the Geographic Reach)

ALTARUM INSTITUTE

Project Title: "Reducing the Burden of Childhood Dental Disease"
Geographic Reach: Michigan
Estimated Funding Amount: $9,383,762

Summary: The Altarum Institute project will test a service delivery model with multiple components that involves direct work with primary care providers and dentists and the development and enhancement of supporting health information technology components. The model targets children enrolled in Medicaid or CHIP, ages 0 to 17.  Specific intervention activities include: 1) improving Identification of Children at high risk of dental disease by developing and deploying oral health risk screening tools, leveraging an existing statewide registry to document screenings and risk status, and delivering technical assistance/training to providers on the use of these tools in primary care and non-traditional settings; 2) linking to appropriate care providers through existing state and regional health information exchange infrastructure to establish electronic referral pathways between medical and dental providers, connecting dentists to the referral system, and monitoring the process, providing following-up on incomplete referrals; 3) promoting evidence-based preventive care by educating and preparing primary care providers and dentists to follow standards of care for preventive services such as fluoride varnish, sealants, and cleanings, providing outreach and education to families of high-risk children, coordinating with existing oral health promotion programs, and better aligning provider incentives to increase provision of preventive care; and 4) enabling care management and monitoring by developing and implementing a statewide dental quality monitoring system using recently validated American Dental Association measure sets.

DETROIT MEDICAL CENTER, VANGUARD HEALTH SYSTEMS

Project Title: "Gateway to Health: An Innovative Model for Primary Care Expansion in Detroit"
Geographic Reach: Michigan
Estimated Funding Amount: $9,966,608

Summary: Detroit Medical Center is receiving an award to test a proposal that would make primary care immediately available to individuals who arrive at 4 major inner city Emergency Departments for non-urgent care by establishing adjacent patient-centered medical home clinics. The initial focus will be on improving the care provided to patients with diabetes or asthma, and Emergency Department "super-utilizers" who have 10 or more visits annually. Medicaid fee-for-service beneficiaries will be the dominant target population. The program will expand to include patients with hypertension, congestive heart failure, chronic obstructive pulmonary disease, HIV, and depression. The design is based on the Nuka model in Alaska.

Team-based interaction with the patient will consist of face-to-face visits, telephone contact, and texting. Services will include an initial assessment of patient expectations, screening for depression, and active engagement of patients in their disease management. Coaches and navigators are essential to the model and are expected to have the greatest impact. The ultimate objective is patient wellness through self-management.

The goals of the project are to reduce emergency room service costs for the subset of emergency room patients with non-urgent care needs while concomitantly increasing access to patient-centered medical homes. Detroit Medical Center also hopes to minimize the potential impact that Medicaid expansion under the Affordable Care Act may have on emergency room utilization.

REGENTS OF THE UNIVERSITY OF MICHIGAN

Project Title: "Michigan Surgical and Health Optimization Program (MSHOP): A Multiplex Patient Risk Stratification and Intervention Program"
Geographic Reach: Michigan
Estimated Funding Amount: $6,389,850

Summary: The Regents of the University of Michigan project will implement the Michigan Surgical and Health Optimization Program (MSHOP), which focuses on- real-time risk stratification and peri-operative optimization for patients undergoing abdominal surgery. The model aims to improve surgical outcomes in two ways. (1) Real-time risk stratification aims to improve the appropriateness of surgery"”in certain high-risk cases, patients and surgeons will avoid prohibitively high-risk surgical care, focusing on medical and palliative management. Further, real-time risk stratification can identify patients who would be good candidates for the peri-operative prehabilitation program. (2) This peri-operative program aims to enable patients to train for surgery, improving their physiology and mindset through an established outpatient program, leading to better outcomes and reduced costs by preventing complications and reducing length of stay. Over the 3-year period MSHOP will be implemented in 40 Michigan hospitals.

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