Nurse listening to a little girl's heartbeat.

Healthy Safety Net: Annual Symposium Highlights a Path to Better Health

Rethinking health care and driving better outcomes for Michigan residents is an all-hands-on-deck effort.

That theme emerged loud and clear at the ninth annual Healthy Safety Net symposium, hosted by Blue Cross Blue Shield of Michigan and held in East Lansing on Thursday, Sept. 19.

Many of the hands doing that transformative work gathered together to learn, network and walk away inspired. The event brought together more than 250 leaders of Michigan’s safety net health care organizations, including representatives from the Michigan Department of Health and Human Services, free clinics, Federally Qualified Health Centers, Rural Health Centers, hospitals, public health providers and other safety net health care organizations.

Dr. Joneigh Khaldun, chief medical executive and chief deputy director for health, Michigan Department of Health and Human Services outlined four main pillars the state is strategically focused on, which informed key topics addressed at the symposium.

  1. Give all kids a healthy start.

Michigan’s infant mortality rate is 6.8 per every 1,000 live births, with African American moms’ experiencing three times the risk of an infant death compared to white moms.

“No matter where a family lives, all babies should be able to be born healthy,” said Dawn Shanafelt, director, Division of Maternal and Infant Health, MDHHS, during a breakout session covering innovations in maternal and child health care.

Maternal health care leaders said building supportive relationships with pregnant women goes a long way in ensuring they access quality prenatal care and go on to have healthy babies. Providing care in new ways and linking to wraparound support services can also help improve infant mortality disparities.

“It is unacceptable that babies die before their first birthday,” said Bradley Garrison, executive director at the Luke Project 52 Clinic in Detroit. “It is amazing what can happen when you give a little hope to somebody.”

Claire Titcombe, maternal and infant health program manager at Grand Rapids’ Cherry Health said parenting classes, home visits and an intense focus on mom’s mental health has helped women see her clinic as a trusted ally, which has improved the care they’re able to deliver.

“We’re trying to have healthy moms, healthy babies and healthy outcomes,” Titcombe said.

  1. Provide families with stability to stay out of poverty.

Presenter Debra Furr-Holden, Ph.D., is the director, Division of Public Health, and associate dean, Public Health Integration, at Michigan State University’s College of Human Medicine. In high school, Furr-Holden’s mom had employment that wasn’t stable. With no health insurance, a case of strep throat went untreated for six weeks, leading to lasting repercussions to Furr-Holden’s voice due to excessive scarring and anxiety about sore throats that persists to this day.

She said poverty and health are often boiled down to an individual level, ignoring the systemic inequities that often influence both at a population level. Programs are often developed to address symptoms of a larger structural problem, which she likened to sprinkling sugar on a baking cake.

“You can’t sprinkle on a fundamental ingredient after the fact and call it a cake,” Furr-Holden said.

She urged people to think about how they can effect change when it comes to “upstream” issues, rather than addressing symptoms that flow “downstream”.

Khaldun said the state is working to expand and simplify access to safety net services for families and to protect gains that have been made through the state’s Medicaid expansion, also known as the Healthy Michigan Plan, which was implemented as part of the Affordable Care Act. New work requirements go into effect in January that could affect eligibility for some Michigan residents.

Todd Anderson, director, Public Policy and Social Mission, Blue Cross Blue Shield of Michigan, said health care costs have grown considerably and much faster than other economic indicators such as GDP and income, meaning families struggling to get by are finding it that much harder to make ends meet. At Blue Cross, shifting from a fee-for-service model to pay-for-value scenarios is one way the health insurer is working to improve outcomes while controlling costs. Reining in rising drug costs is another top priority, he said.

“Addressing costs effectively requires collaboration,” Anderson said.

  1. Serve the whole person.

Khaldun said the World Health Organization’s definition of health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity,” informs work being done at the state level. Addressing food and nutrition, housing and other social determinants of health is critical to optimal health.

Other ways the state is working toward a bigger picture of health includes looking at integration between physical and behavioral health, long-term support services and reducing opioid and drug-related deaths. A recently announced Michigan Opioid Partnership, which includes Blue Cross Blue Shield of Michigan and the Blue Cross Blue Shield of Michigan Foundation, will combine public and private funds to support a mission to decrease opioid overdoses and deaths through prevention, treatment, harm reduction and sustained recovery.

Speakers who addressed innovative approaches to improving social and economic determinants of health included Nancy Lindman, director, Public Policy and Partnerships, Michigan Association of United Ways; Diane Conners, senior policy specialist, Groundwork Center; Ryan Hertz, president and CEO, Lighthouse of Michigan; and H. Luke Shaefer, director, Poverty Solutions, the University of Michigan.

  1. Use data to drive outcomes.

At a state level, Khaldun said this means all administrations and departments are managing to outcomes and investing in evidence-based solutions. Dr. Renuka Tipirneni, assistant professor of internal medicine, Institute for Healthcare Policy and Innovation, University of Michigan Medical School, outlined the ways data can highlight what’s working and where improvement might still be needed in her presentation on the Healthy Michigan Plan’s impact on health outcomes and other factors since its implementation.

She urged everyone in attendance to “keep doing what you’re doing,” and to look for opportunities to forge collaborations and partnerships that drive results.

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Photo credit: SDI Productions

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