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This site visit explored the forces shaping the delivery of health care in Detroit. Health care providers in Detroit face the twin challenges of controlling costs and serving a bifurcated metropolitan area that includes large numbers of uninsured, low-income, and vulnerable residents as well as more prosperous residents of a reviving inner core and the surrounding suburbs and counties. The program looked at the underlying economic, social, and physical conditions that make improving the health of the city's residents extremely challenging. Efforts to contain costs through payment innovations such as the Blue Cross Blue Shield of Michigan's Physician Group Incentive Program and accountable care organizations (ACOs) were featured. The program also focused on the status of the health care safety net serving Detroit's low-income residents and the likely effects of Medicaid expansion and other market dynamics on patients and providers. Participants visited the city’s two large health care systems, Henry Ford Health System and Detroit Medical Center, and the CHASS Center, a federally-qualified community health center. They conversed with experts, community leaders, public officials, providers, and individuals representing employers and unions. A report of participants' impressions was published on April 30, 2014.


Site visit report. Detroit, MI, February 19-21, 2014. Report published April 30, 2014.

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