On November 8, 2022, the Washtenaw Health Initiative Steering Committee reviewed 2023 priorities against the organization’s budget.
WHI executive officers proposed to sunset the Medicaid and Marketplace Outreach and Enrollment (MMOE) workgroup and the Unified Needs Assessment Implementation Plan Team Engagement (UNITE) project. Their reasoning? Both projects can continue without the support of the WHI and resources are needed for other pressing priorities.
Below we highlight how each project started, key accomplishments to date, and reflections on the transitions.
Preparing for ACA rollout
An early goal of the WHI was to help local agencies prepare for the rollout of the Affordable Care Act. On June 28, 2011, WHI leaders operationalized this goal by launching one of the WHI’s first projects, Community Outreach for Medicaid Enrollment. Debbie Jackson, the current director of community impact at United Way of Washtenaw County, chaired the group, which met regularly from 2011 onward.
On October 7, 2011, the WHI Steering Committee decided that the Community Outreach for Medicaid Enrollment committee would become an official WHI workgroup titled Medicaid and Insurance Exchange Enrollment and Eligibility. The group was later renamed Medicaid and Marketplace Outreach and Enrollment or MMOE.
The work group’s first initiative was hosting a series of information sessions with community groups such as Barrier Busters, Blueprint for Aging, and the Washtenaw Health Plan. The sessions gathered input and feedback from community leaders on how to structure an outreach strategy for Medicaid enrollment.
Next, the group prepared for the first open enrollment period in 2014. The workgroup identified safety net clinics and social service organizations that might be interested in helping enroll patients in the marketplace. MMOE members also educated small business owners about the Affordable Care Act’s small business Marketplace and associated benefits.
For each open enrollment period from 2014 onward, the MMOE workgroup, with representatives from the Washtenaw Health Plan, Trinity Health, and Michigan Medicine, helped residents enroll in the marketplace.
“MMOE was seminal in our history and our early efforts to bring entities together when the ACA was rolling out,” says WHI Co-Chair Brent Williams.
During the 2021 open enrollment period, WHI member organizations processed approximately 1,306 Marketplace applications and questions and 2,472 Medicaid applications. And in 2022, MMOE made an intentional effort to focus on aging adults. Work included enhancing aging adults’ insurance plan comprehension and ensure financial literacy for medical billing.
During the nine open enrollment periods that took place throughout MMOE’s tenure, the group hosted dozens of enrollment events, distributed flyers and yearly articles with information about local enrollment resources, educated volunteers about health plans, and more. This work was fundamental in preparing county agencies to continue enrollment efforts in the future.
Decision to sunset
“The WHI helped forge meaningful relationships between each participating agency, and I’m confident that these collaborations will continue outside of the Washtenaw Health Initiative,” said Williams.
At the MMOE meeting on December 12th, the group reflected on accomplishments over the past decade. The group will meet once more in the new year to map out future communications strategies between the participating agencies.
Unified Needs Assessment Implementation Team Engagement (UNITE)
Fueling collaboration among competitors
In 2015, the WHI created a space for collaboration between three of the largest non-profit health systems in our region: Trinity Health Ann Arbor, Chelsea Hospital, and Michigan Medicine. The collaboration was created to achieve requirements of the Patient Protection and Affordable Care Act (PPACA) that mandated hospitals identify and address community health needs. Previously, the hospitals had each conducted assessments independently, but in 2015, the hospitals explored ways to conduct a joint assessment.
The group was named Unified Needs Assessment Implementation Plan Team Engagement or “UNITE.”
The WHI helped the three systems create relationships, develop shared goals, assemble data, and share results.
Since UNITE launched in 2015, partners have conducted three health systems community health needs assessments (CHNAs) and three implementation plans in 2016, 2019, and 2021.
The assessments use data from Washtenaw County Public Health Department and area health coalitions. The UNITE group also uses primary data sources from screening patients in the three systems.
The WHI has helped with this process by providing administrative and scheduling support. Specifically, WHI staff facilitated monthly meetings, organized data retreats for analysis, and provided writing and analytic support for the reports.
Latest community health needs assessment and implementation plan
The 2021 CHNA revealed three regional health priority areas:
- Mental Health and Substance Use Disorders
- Obesity and Related Illnesses
- Pre-conceptual and Perinatal Health
When analyzing each priority area, the hospital systems considered social determinants of health (SDOH) and health equity, reflecting on the hospitals’ commitment to address upstream factors contributing to poor health.
And in 2021, as in 2016 and 2019, the group brainstormed how to leverage their combined resources to address these priority areas through an implementation plan designed to improve community health and health equity.
The most recent 2022-2024 implementation strategy evaluates the root causes of the three priority areas—things like housing, poverty, and social isolation.
In the implementation plan, each priority area has a related goal and objectives. For example, the accompanying goal of the first priority area, mental health and substance use disorders, is to reduce the prevalence and negative impacts of substance use and mental illness in greater Washtenaw County.
Continuing the work without WHI support
After three cycles of conducting CHNAs and producing implementation plans with the support of the WHI, the health systems are confident they can complete the next iteration of the work on their own. Additionally, the health systems now have embedded staff to help support this process.
“It’s been a pleasure to work with health systems and administrations,” says Erica Matti, WHI UNITE staff representative. “Seeing the health systems collaborating toward shared goals is a wonderful example of collective impact.”
For more information on the development, evolution, and conclusion of various WHI workgroups, visit our historic timeline.