Disease prevention and healthy living: Rick Snyder's health care priority for Michigan?
Melanie Maxwell | AnnArbor.com
The amount the state's Public Health Administration spends on “promotion of healthy behaviors": $975,900.
That figure is dwarfed by the $9.88 billion in federal funds and $4.19 billion in state dollars Michigan appropriates for the Department of Community Health, which oversees the 1.8 million Michiganders who receive Medicaid benefits.
That disparity reflects a limited commitment among the federal and state governments to the concept that a healthier population leads to fewer health care problems — and lower costs for everyone.
But Gov.-elect Rick Snyder, who co-founded an Ann Arbor-based company whose software helps people make healthier decisions, is expected to place a greater emphasis on disease prevention and wellness initiatives.
Snyder was a co-founder and personal investor in Ann Arbor-based HealthMedia until it was sold in a blockbuster deal to Johnson & Johnson in late 2008. He once cut personal checks to pay the salaries of HealthMedia employees when the company hit a rough patch around 2001.
His commitment to the company’s philosophy — that health care costs can be lowered by improving the health of the general population — provides insight into the approach he'll take as Michigan’s 48th governor starting Jan. 1.
“It’s nothing we’ve talked about, but I would be surprised if he doesn’t put an emphasis on wellness,” said former HealthMedia CEO Ted Dacko, who now leads Ann Arbor-based consulting firm Arbor Dakota Strategies. “I mean, he’s the guy who talked me into coming to HealthMedia because he understood this issue 10 years ago. It’s something we as a state need to do.”
Bill Nowling, Snyder's spokesman, said the governor-elect
would take a "serious" look at using his "value for money" budgeting
system to find new funds for disease prevention and wellness
"Preventative health is going to play a key role because it’s one of
the areas where we can really save money in the long term," he said.
"The key thing is going to be working with the federal government to
secure the waivers we need to administer the programs differently."
Michigan’s total spending on healthy living initiatives and preventing chronic disease is scattered through several divisions of the Department of Community Health. The department spends some $30.7 million for its “Chronic Disease and Injury Prevention” division, though $23 million of that is federal money.
Of those dollars, the state says $4.6 million is devoted to smoking prevention, and another $21.2 million is dedicated to “chronic disease control and health promotion.”
A separate division called the Public Health Administration has a $17.8 million budget, though $9.2 million was spent on health records and statistics. And another $5 million spent on “public health projects” came from the federal economic stimulus bill. This department spends $975,900 on “promotion of healthy behaviors.”
In a paper detailing his health care policy proposals, Snyder said Michigan could save more than $1 billion “by improving the management of Medicaid, expanding access to care, fielding innovative health IT systems, and identifying health problems and focusing on wellness prevention early, before issues become severe or chronic.”
Snyder has called for the state to consider launching a program in which certain Medicaid patients would be eligible to participate in so-called “patient-centered medical homes,” a concept modeled after similar programs in Texas and New Mexico. The patient-centered medical homes, generally targeted at poor residents with several major health problems, seek to reduce costs by eliminating duplicate medical services and “silos” that cause confusion among doctors and high costs for the state, Snyder says in his paper.
Melanie Maxwell | AnnArbor.com
Snyder has also called on the state to pursue federally qualified health centers, pilot health projects and public-private partnerships. He’s said the state should spend more on mental health services.
But he regularly emphasizes the importance of encouraging good behavioral decisions to reduce health care costs.
“Citizens should be educated and encouraged to get routine vaccinations and examinations, and to make healthy lifestyle decisions concerning nutrition, exercise, smoking, drinking and other factors,” he says in his health care reform paper.
To place a greater emphasis on wellness and prevention, the state needs to consider restructuring its public health division, said Marianne Udow-Phillips, director of the Center for Healthcare Research and Transformation, a partnership between the University of Michigan and Blue Cross Blue Shield of Michigan.
Udow-Phillips, who served as director of the state’s Department of Human Services from 2004 to 2007 under Gov. Jennifer Granholm, said the public health division should remain part of the Department of Community Health but that the Medicaid program should be moved back under the auspices of the Department of Human Services. This would allow public health issues to be given greater prominence, she said.
Udow-Phillips said Tuesday morning on the “Lucy Ann Lance Business Insider” on 1290 WLBY-AM that wellness and disease prevention had “gotten much less priority over the years than I think they deserve.”
“The huge issues in our state really have to do with chronic disease. We are a very high state in terms of our overweight status, we’re higher than the national average on smoking, we have these significant issues with (premature births),” Udow-Phillips said. “These are all public health issues, and they’re all things that need a concentrated focus, and it’s really hard to do that when you’re blended together with the Medicaid program that has its own issues.”
Whether Snyder plans to devote more funding to wellness and disease prevention isn't yet known.
But his “10-point plan” to “reinvent Michigan,” which he regularly cited during his campaign, says he “strongly believes in prevention, wellness and personal responsibility.
“He wants to move Michigan to a more patient-centered model to achieve large cost savings, promote wellness, and improve overall service quality,” the plan states.
The role of software
Reducing health care costs is a key objective of HealthMedia’s health coaching technology, which helps users identify risky behaviors and make better lifestyle decisions.
The firm’s customers include major health plans such as Aetna and several Blue Cross Blue Shield entities and major employers like eBay and Ace Hardware.
Public workers have been customers of HealthMedia, too. Former Republican U.S. presidential candidate Mike Huckabee, for example, turned into a public proponent of HealthMedia after the state of Arkansas adopted HealthMedia’s software for state employees and said it led to “productivity savings of $2,300 per employee.”
Caren Kenney, director of communications for HealthMedia, declined to comment on whether Snyder’s ascension to the governorship could benefit HealthMedia.
But she said HealthMedia would support an increased focus on wellness and disease prevention.
“If that’s part of his platform, that would certainly be something that we applaud,” Kenney said. “It’s not just Michigan. You’re seeing it among employers that are recognizing it as important and investing it in. It’s really a national focus. We applaud Rick and anyone else who places an emphasis there.”