Evaluation of the Healthy Michigan Plan Section 1115 Community Engagement Requirement Waiver
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 入组人数
- 892
- 试验地点
- 1
- 主要终点
- Number of hours worked, recorded
研究概览
简要总结
The Centers for Medicare & Medicaid Services (CMS) approved the renewal of the Healthy Michigan Plan (HMP) Section 1115 Demonstration Waiver on December 21, 2018, for the period January 1, 2019-December 31, 2023. This waiver provides approval for the state to require Medicaid expansion beneficiaries ages 19-62 to complete and report 80 hours per month of community engagement as a condition of eligibility, among other waiver provisions, beginning January 1, 2020. Community engagement activities include employment, education, job training, job search activities, participation in substance use disorder (SUD) treatment, or community service.
The State of Michigan will implement a randomized controlled trial (RCT) to evaluate the impact of community engagement requirements on Medicaid enrollment, health insurance coverage, self-reported health status, access to and utilization of health services, earnings, and employment, compared to a control group of HMP enrollees exempted from the community engagement requirement for purposes of the evaluation.
详细描述
Goals of the Demonstration
As stated by the Michigan Department of Health and Human Services (MDHHS), the overarching goals of the Healthy Michigan Plan (HMP) demonstration are to increase access to quality health care, encourage the utilization of high-value services, promote beneficiary adoption of healthy behaviors, and implement evidence-based practice initiatives.
The main objectives of MDHHS for HMP include:
- Improving access to healthcare for uninsured or underinsured low-income Michigan residents;
- Improving the quality of healthcare services delivered;
- Reducing uncompensated care;
- Strengthening beneficiary engagement and personal responsibility;
- Encouraging individuals to seek preventive care, adopt healthy behaviors, and make responsible decisions about their healthcare;
- Supporting coordinated strategies to address social determinants of health in order to promote positive health outcomes, greater independence, and improved quality of life;
- Helping uninsured or underinsured individuals manage their health care issues;
- Encouraging quality, continuity, and appropriate medical care.
The evaluation for this demonstration is focused on examining:
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 19 Years 至 62 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Enrollees eligible for the HMP community engagement requirement, including:
- •Adult HMP beneficiaries ages 19-62 who are not otherwise exempt.
排除标准
- •Enrollees exempt from the community engagement requirement includiung:
- •Pregnant women
- •Primary caregivers of a family member under six years of age (limited to one caregiver per household)
- •Caretakers of a dependent with a disability who needs full-time care (allowed for one beneficiary per household if there is only one dependent with a disability who meets the criteria specified above in the household)
- •Caretakers of an incapacitated individual even if the incapacitated individual is not a dependent of the caretaker
- •Beneficiaries considered medically frail
- •Beneficiaries currently receiving temporary or permanent long-term disability benefits from a private insurer or from the government
- •Beneficiaries diagnosed with an acute medical condition that would prevent them from complying with the requirements
- •Beneficiaries who have been incarcerated within the last six months
- •Beneficiaries currently receiving unemployment benefits from the state
- •Beneficiaries under 21 years of age who had previously been in foster care placement in Michigan
- •Full-time students.
结局指标
主要结局
Number of hours worked, recorded
时间窗: 4 years
Number of hours worked (state unemployment insurance data)
Insurance coverage
时间窗: 3 years
Insurance coverage (self-reported uninsurance, employer-sponsored insurance, other types of insurance)
Employment record
时间窗: 4 years
Employment status (state unemployment insurance data)
Job training participation
时间窗: 3 years
Job training participation (self-reported)
Earnings
时间窗: 4 years
Income (state unemployment insurance data)
Income
时间窗: 4 years
Income (Medicaid eligibility data)
Days poor physical health
时间窗: 3 years
Days poor physical health (self-reported)
Enrollment in Medicaid
时间窗: 4 years
Enrollment in Medicaid (Medicaid eligibility data)
Days poor mental health
时间窗: 3 years
Days poor mental health (self-reported)
Employment
时间窗: 3 years
Employment status (self-reported)
Educational enrollment
时间窗: 3 years
Educational enrollment (self-reported)
Number of hours worked
时间窗: 3 years
Number of hours worked (self-reported)
Days limited in usual activities due to health
时间窗: 3 years
Days limited in usual activities due to health (self-reported)
Health status, overall
时间窗: 3 years
Health status, overall (self-reported)
次要结局
- Hospital admissions in past 12 months(4 years)
- Enrollment in SNAP(4 years)
- Credit report outcomes(4 years)
- Financial well-being(3 years)
- Emergency room (ER) visits(4 years)
- Material hardship(3 years)
- Enrollment in TANF(4 years)
研究者
John Ayanian
Director, Institute for Healthcare Policy and Innovation
University of Michigan