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Perspectives on Michigan Value-Based Purchasing & Pay for Success

In a new report, LISC's Pay for Success team and its partners built out the tools to address social determinants of health leveraging the innovative Pay for Success model. Their research included interviews with managed care organizations and two focus groups to collect participant reflections on their personal experiences. Due to timing, the focus group data was not incorporated into the original report. Below, the PFS team walks through the additional perspectives that were gained from our partner, CHRT's, focus group research. 

Follow Up Perspectives of Medicaid Beneficiaries Who Participated in the Diabetes Prevention Program

LISC and the National Kidney Foundation of Michigan (NKFM) engaged the University of Michigan’s Center for Health and Research Transformation (CHRT) to independently evaluate the knowledge of managed care organizations regarding the Diabetes Prevention Program (DPP) and Pay for Success (PFS), their willingness to participate in the LISC-NKFM PFS initiative, and barriers to implementation among Medicaid clients. A summary of the interview findings is published in Michigan Value-Based Purchasing and Pay for Success: Tools to Expand Diabetes Prevention Program and Address Social Determinants of Health.  

To get the complementary perspective of Medicaid beneficiaries, the CHRT research and evaluation team conducted two focus groups to collect participant reflections on their experiences with the DPP. Due to project timing, these results were not incorporated into the Michigan Value-Based Purchasing and Pay for Success white paper. However, they provide additive insight into implementation of interventions that address social determinants of health for Medicaid eligible populations.

CHRT worked with NKFM to identify former DPP participants who self-identified as Medicaid beneficiaries at the time of program enrollment. Through two focus groups in June 2019, CHRT explored individual motivation to participate in the DPP, skills and knowledge learned in the program, individual lifestyle changes made, most helpful aspects of the program, biggest challenges and opportunities for improvement with former participants. As social service organizations and insurers continue exploring tools to address social determinants of health, working with beneficiaries to improve service delivery can strengthen outcomes. Through the focus groups, CHRT found that participants:

  • Valued the education and mentoring they received from teachers and the support they received from participating in the intervention with a group of peers;
  • Did not experience substantial barriers to participation, but appreciated opportunities for flexibility like online or virtual options;
  • Continued to make lifestyle changes related to healthy eating and physical activity after the end of the intervention. Participants indicated this was an area where opportunities exist to offer continued support from mentors and peers post intervention; And
  • Indicated the largest barriers were access to physical activity space and healthy foods.

Additional findings are available in full report here.