THE UNIVERSITY OF MICHIGAN HEALTH SYSTEM  
MEDICAID MANAGED CARE GME PROJECT

The Project is set up as a set of educational programs sponsored by four primary care departments –Family Medicine, Internal Medicine (General Medicine and Geriatric divisions), Obstetrics/Gynecology, and Pediatrics. The Project Core is made up of leadership from each department, as well as the Associate Dean for Graduate Medical Education and a representative from M-Care, the Project's managed care partner. The Core provides direction and coordination for the Project's curriculum development, its implementation, and its evaluation.

Core Activities

The Core has been busy during the last two months of Summer. The most extensive activity begun during this period has been the start of development for three teaching modules that will focus on managed care report cards. With assistance and input from varied branches of the University Medical System, we are creating report cards that will reflect the actual practice sites in which our learners operate. The modules will examine resource utilization measures via physician profiles from M-Care, patient satisfaction survey results from the Office of Planning and Marketing, and HEDIS measures provided by the Clinical Affairs Office.

The newly re-organized steering committee of the Obstetrics/Gynecology Department has been working hard and utilizing the experiences of the other department's in the Project as it has developed a managed care curriculum tailored to its residents. The fruits of their efforts, a two-week rotation that includes home-visits, sitting in on an M-Care committee, guided reading, participation in the Pediatrics seminar series, and completion of the Tufts CD-ROM on managed care, will be deployed during the second half of October.

Core leadership went to Lansing for the Project's Quarterly Meeting on September 10 and returned to Ann Arbor with four homework assignments, half of which were due by the end of the month. The assignments completed in September consisted of answering questions for a Outcome - Instrumentation Flow Sheet and collecting examples of each evaluation instrument used by the different departments involved the Project, along with reports on the results from these evaluations.

As year-end data became available, the Core's budget meetings focused on significant unspent variances from several departments. It was decided to ask for a no-cost extension, to allow the Project to continue its development activities through September 2000. A formal request for the extension was made, approval was given, and an amendment to the grant is forthcoming.

At the monthly Core meeting in September there was a demonstration of the instructional CD-ROM from the Tufts Managed Care Institute. That, coupled with what had been seen of the product at the Quarterly Meeting, convinced that Core to begin negotiations with Tufts to allow us to include their training package in the Project's Web site.

Construction was begun on a Web site for the Project in late July and completed by the end of August. Administrative complications have delayed its appearance on-line, but it should be up and running by mid-October. The Medicaid Managed Care Web site will be a resource for residents of every department in this Project, with internally developed content as well as links to other relevant sources of information

Contacts were made with residency programs involved with managed care at Harvard Pilgrim Medical Center and at the University of Pennsylvania Health System.

Preparation for site visits to those institutions has begun.

At the end of August, copies of the Project's "Caring in the Community" videotape were sent to members of the Health Policy Committee in the Michigan Legislature and to local legislators as well.

The evaluations data base has been constructed and analytic methods for evaluation instruments were refined with assistance from members of the Department of Medical Education (including Larry Gruppen and Linda Wray). Administration of the Knowledge Assessment and Attitude Surveys has continued in all departments.

The Pediatrics Seminar Series is on-going, refined and uploaded to a Web site (http://www.ped.med.umich.edu/managedcare/) in late August. Rotations have proceeded as scheduled for learners in Geriatrics, Pediatrics, Family Medicine, and General Medicine. The new rotation for Obstetrics/Gynecology residents begins this month.

Administrative complications, in mounting the Web site, in collecting information for the Core Data Set, and in collecting patient information needed to create HEDIS measures, have been and are likely to continue to be a source of difficulty in moving forward with the Project.

Back to Project Overview