Integrated Health Partners (IHP)
IHP offers Introduction to Team Based Care and Patient Engagement Foundations trainings throughout the calendar year. All 2026 training dates are available for registration through the registration link below. Both trainings are 8:30 a.m. to 5:00 p.m.
| Trainings | Upcoming 2025 Dates | Registration Link |
| Introduction to Team Based Care | January 7th, February 11th, March 3rd | Register here |
| Patient Engagement Foundations | January 14th, February 4th, March 5th | Register here |
Together with Advance Care Planning leaders within our state, MDHHS created MI-POST trainings that are now available on the MDHHS MI-POST website. These leaders include representatives from Ascension, Corewell Health, Covenant HealthCare, Gogebic Medical Care, Munson Medical Center, MyMichigan Health and Trinity Health Care, Health and Hospital Association, Michigan Home Care and Hospital Association, Healthcare Association of Michigan, private consultants, and state partners from Licensing and Regulatory Affairs and the Division of EMS and Trauma.
MDHHS has issued a new Michigan Physician Orders for Scope of Treatment (MI-POST) form for adult patients with advanced illness or frailty. This medical order is signed by the patient or patient representative (enacted Patient Advocate or Legal Guardian) and their health care provider and is used to direct care when the patient is unable to verbalize their treatment preferences. MI-POST is an optional one page, two-sided medical order with a person’s wishes for care in a crisis. MI-POST is part of the advance care planning process that includes choices about cardiopulmonary resuscitation (CPR), critical care, and other wanted medical care. It is intended to guide care only if the person cannot tell others what to do at that time. Health care providers who may sign this order include physicians, nurse practitioners, physician’s assistants. Unlike the out of hospital DNR order, the MI POST does not require witnessing, and must be reaffirmed annually and when the patient changes level of care. The MI-POST form is available in Spanish, Arabic and English.
As of Friday, June 30, patients and their health care providers will be required to use the new MI-POST form, available on the MI-POST website. MI-POST forms completed on the old version of the form before
Friday, June 30, will be considered valid one year from the completion date or until a circumstance that requires reaffirmation or revocation of the MI-POST form, as detailed on the form instructions.
MDHHS has created trainings specific to Licensed Care Facilities, Clinicians and Hospital Care Teams, Emergency Medical Services/Medical Control Authorities, and community members on utilizing the MI-POST form, including completing the MI-POST form, processes for reaffirmation or revocation, and compliance with the MI-POST form. MDHHS has also made available volunteer trainers to facilitate training sessions on the MI-POST form process on a limited basis.
Facilities interested in training resources should reach out to MDHHS-MI-POST@michigan.gov. For more information on the MI-POST form, Frequently Asked Questions, the MI-POST Administrative Rules, Public Act 154 of 2017, and training resources, please visit the MI-POST website.
Community Information Exchange (CIE) capacities enable organizations using different technologies to share information while providing social care to people in need. CIE can also facilitate the aggregation of data about community resources, and communities’ needs, and to inform policy change that promotes more equitable and effective distribution of resources and programming. The Michigan Social Determinants of Health (SDOH) Strategy, entitled “Michigan’s Roadmap to Healthy Communities,” includes CIE as an essential structural intervention for advancing health equity.
In the “Bridge to Better Health” report, the Michigan Health Information Technology Commission (MHITC) also highlights that the statewide development of CIE is a prioritized to support the establishment of social care data standards. To inform the implementation of statewide CIE, MDHHS convened a Community Information Exchange Task Force in August 2022. The Task Force met through July of 2023, bringing together representatives of community-based organizations (CBOs), health care organizations, health payers, health IT, and governmental entities to understand the existing infrastructure of CIE activities in Michigan, analyze the needs of various partners, assess the capacities of CIE that are needed in the field, and make recommendations for actions that the state government and other actors can take to support the information ecosystem of health, human and social service providers in Michigan.
The CIE Task Force has issued a set of recommendations with strong consensus alongside a high-level roadmap for implementation. These recommendations include:
While there is broad consensus across healthcare, payors, government, and communities on the need for better data and information sharing to adequately address social drivers of health, in the absence of federal guidance and dedicated funding for states to promote CIE it is critical that Michiganders coalesce around core values and principles to promote equitable, effective, and interoperable social care data exchange. This report establishes a roadmap for Michigan to develop state-wide CIE infrastructure driven by the goal of health equity.
You can find the CIE Task Force Final Report here. Here is a recording of the CIE Task Force Final Report Webinar, where MDHHS staff and CIE Task Force members walk through the final report and recommendations. If you have any questions or thoughts, please reach out to MDHHS-SDOH-PolicyandPlanning@michigan.gov
MiHIN is sunsetting their Making Choices Michigan (MCM) work in Advance Care Planning (ACP) training, individual and group ACP facilitation and workgroups to help advance the practice of ACP training and Advance Care Document (ACD) completion in Michigan.
As part of this change, MiHIN compiled a whitepaper to identify ways to improve the robustness of advance care planning in our state, together with their stakeholders and partners at Michigan Department of Health and Human Services (MDHHS) and the HIT Commission. This white paper outlines the six most prominent and agreed-upon solutions to increasing the documentation and interoperability of ACDs, as identified by Michigan’s healthcare professionals.
This allows MiHIN to focus on the ACP role that they can do best — delivering value in the meaningful exchange of health data to support serious illness care. MiHIN will concentrate on the completion and movement of patient advocate designations and information to support care teams in serious illness conversations through our Advance Care Document (ACD) use case. Other organizations in the state will continue to provide training, including MyMichigan (see their offerings in the training list at the end of this newsletter).
MiHIN is proud of the work that they have accomplished together with the Michigan community. The MiHIN Making Choice Michigan website will be retired by 10/1/2023. They will continue, however, to provide the access to multilingual materials such as the Advance Directive – Durable Power of Attorney for Health care (Patient Advocate Designation) and Patient Advocate Guide which can help individuals and organizations support choice-making in serious illness conversations. Questions about the change can be addressed to lisa.nicolaou@mihin.org.
Medicare open enrollment will soon be upon us, occurring each year from October 15 to December 7th. If you have patients who are confused about Medicare benefits and available plans, the Michigan Medicare Assistance Program (MMAP) is there to help. Their mission is to educate, counsel, and empower Michigan’s older adults and individuals with disabilities, and those who serve them, so that they can make informed health benefit decisions.
MMAP is a nonprofit (501c3) federally and state-funded organization. Counselors are trained in Medicare and Medicare/Medicaid dual enrollment law and regulations and health insurance counseling but are not connected with any insurance company, nor are they licensed to sell insurance. MMAP also has expertise in Medicare supplemental insurance, long term care insurance, and Medicare Health Plans options.
MMAP sites are housed in regional Area Agencies on Aging, County Departments on Aging, Senior Services Agencies, Commissions on Aging and other similar organizations located throughout Michigan. People can connect with an MMAP counselor at https://mmapinc.org/ or by calling 1-800-803-7174.
While the transition to value-based payment is taking form, many health care services are still reimbursed on a fee-for-service. Michigan Multipayer Initiatives Steering (MMI) Committee and Payer Leaders partnered with the Michigan Health Information Network (MiHIN) to file comments to CMS on the 2024 proposed Physician Fee Schedule which guides Medicare fee-for-service payment. Our great thanks for the many primary care practices, state organizations, and healthcare leaders who contributed so much to the formation of the language recommendations.
MiHIN handles an enormous amount – almost six billion! – inbound and outbound ADT messages each year. Only a handful of other HIEs nationally can say the same.
Because MiHIN executes more than just a one-to-one ADT notification by standardizing, normalizing, measuring conformance and pushing the data to many members of a patients care team, instead of just a PCP, they have hit the limits of their current processing platform.
As with all good things – there are opportunities for improvement. Throughout 2023, some organizations have experienced delays at times, and MiHIN has worked to identify and quickly resolve challenges that affected the routing and normalization of outbound ADTS to receiving organizations. To decrease these kinds of issues and improve servicing and continuity, MiHIN will be migrating to a new FHIR-based integrated technology platform.
The new platform is designed to run a true integration engine that employs cloud technologies, making it more durable, reliable, and performant. Instead of relying on a single off-the-shelf engine, they will be able to run as many servers as necessary to process like a hive, allowing MiHIN to scale operations.
In the coming weeks and months, the MiHIN team will work directly with participants on their migrations needs, goals and plans. Visit their site to learn more about MiHIN’s Integrated Technology platform.
As the digital pillar undergirding the structures that support Michigan’s learning health systems, MiHIN monitors the environment for issues related to regulatory and legal frameworks and behavioral expectations. July’s THE DOWNLOAD featured Shreya Patel, MiHIN Chief Policy and Privacy Officer, who presented a broad overview of general themes taken from recent policies that impact our ecosystem, including insights on information blocking, behavioral health information exchange and cross-sector data sharing.
Information Blocking
Information blocking is an initiative out of the office of The National Coordinator for Health (ONC), that prohibits actors from engaging in practices that are likely to interfere with the access, the exchange, or the use of electronic health information. The three sets of actors subject to this rule are healthcare providers (which is a term used very broadly and covers almost all healthcare stakeholders aside from state entities and payers), health information networks or exchanges (like MiHIN), and developers of certified technology as defined under the ONC Health IT Certification Program.
Enforcement parameters were released this year and noted that actors could be subject to up to $1,000,000 in fines if they are found liable for information blocking. The Office of the Inspector General, the entity in charge of enforcement, will be the final determiner of whether claims are brought against an actor or not.
MiHIN supports our stakeholders staying compliant with this rule. Participation in the MiHIN network alone shows good faith in exchange with a variety of participants. MiHIN can also assist with internal flows or documentation surrounding how participation in our network can help our participants remain compliant when in receipt of a request to share information. Documentation that displays uniformity in how we’re responding to a request has been key to this initiative.
Behavioral Health Information Exchange
42 CFR Part 2 is a federal regulation that preceded HIPAA and protects the confidentiality of substance use disorder records that come from defined Part 2 facilities. This regulation is in place to prevent the stigmatization and discrimination that can come from other entities or individuals finding out that someone receives treatment at a Part 2 facility.
MiHIN’s Chief Policy and Privacy Officer often receives questions regarding differences between behavioral health information (more generally) and Part 2 information. The way she describes it is that behavioral health is the large, overarching umbrella that covers many types of information, including mental health information, substance use disorder information, information coming out of general medical facilities, as well as information coming from defined substance use disorder facilities. Those defined substance use disorder facilities would impart Part 2 information and are just one part of the giant behavioral health bucket.
According to guidance provided by The Substance Abuse and Mental Health Services Administration (SAMSA), if behavioral health information is shared from a more general medical facility, that information is not considered to be Part 2 information and can be shared in the same way that other information is shared under HIPAA. It is only when information flows from those defined Part 2 facilities must we ensure that consent is in place by the individual. The newly proposed rule for Part 2 did not take away any of the requirements that consent is needed prior to sharing Part 2 information, but it did clarify that one single consent can be ongoing.
MiHIN’s Electronic Consent Management Service use case was created to capture consent at the Part 2 facility, which is still a requirement that must be in place. We encourage all stakeholders to participate in our collaborative forums regarding our e-consent efforts to delve into how our solutions adapt with changes in the regulation, including but not limited to offering privacy tagging or segmentation solutions.
Cross-sector data sharing
Cross-sector data sharing is a key emerging federal priority. Cross sector data sharing is the sharing of healthcare information in a bi-directional manner with community organizations or actors who are not typically classified in the health care space, but ones that still do perform important services for preventative purposes or need important healthcare information.
The hospital Inpatient Prospective Payment System rule, or IPS, and the Long Term Care Hospital and Prospective Payment System rule or LTCHPPS are published by CMS and set base payment rates for certain services or certain items. Typically, these prospective payment system rules propose changes to hospital reporting requirements, and those dictate how entities will receive Medicare funding for that year in subsequent years, depending how readily and well they meet certain metrics.
The 2023 rules emphasized health, equity, social determinants of health and health related social needs, pushing for hospital commitment to help equity measures and encouraging improved data, collection, data, analysis, quality, improvement, and leadership engagement from hospitals as well.
These rules wanted to examine how social determinants of health could be attributed to clinical and non-clinical factors, which supports similar regulatory efforts to bring SDOH information into the HIPAA realm, so that it can be shared more readily. HHS, too, has a proposed rule out on changes to the HIPAA privacy rule which would clarify if and how to share information with CBOs.
Through our cross-sector data exchange program, MiHIN has been proactive and collaborating in multiple forms to answer the question of how best to share this information across our network, so that hospitals are able to meet this measure more easily, and other health care stakeholders are also able to exchange this information.
These conversations have been challenging, requiring legal interpretation by many organizations who differ in their interpretation of the language and the guidance that HHS has put out thus far. MiHIN, through our pilot work and our vendor community of practice, is trying to reach a shared understanding that is functional for information exchange, so that sharing may occur sooner rather than later, allowing our stakeholders to move forward with these initiatives without being so dependent on the release of final rules.
For additional information on these and other policies, please visit www. https://mihin.org/the-download or contact us directly at help@mihin.org.
Michigan Institute for Care Management and Transformation (MICMT)
With a focus on pediatrics, MICMT is offering a live 1 hour webinar January 17th Collaborative Communication in Special Education presented by Taryn Francis. In the coming weeks, registration will open for a pediatric ethics webinar once details are finalized. Please be sure to check our event calendar to view a list of upcoming trainings, including live webinars. For an at a glance view, please find the event calendars and event flyers in the “News” section here. Questions and concerns can be shared at https://micmt-cares.org/contact
Space is available for our new training series, titled, “Advanced Engagement.”
During this highly interactive, multi-session training series, the learner will advance their skills in Motivational Interviewing. Learners will be offered multiple learning methods such as didactic discussion, small and large group practice, introspection, videos, hypothesis generation, low stakes testing, and self-study. Evaluation of progress will be measured with knowledge tests and skill observation with individualized feedback and coaching.
This training series meets the 2023 BCBSM scorecard requirements for the advanced engagement training. Additional information can be found on the Mi-CCSI website at https://www.miccsi.org/training_event/advancing-skills-in-patient-engagement-training/.
| Month | Team Based Care | Engagement | Palliative Care |
New! Advanced Engagement |
|
November |
7th | 8th |
Nov. 9 – Dec. 21st |
|
| December | 13th | 14th | 12th |
|
We would also like to direct folks to our website to learn more about the “Palliative Care” training. On the website is an example of an evidence-based serious illness conversation, which is covered in the Palliative Care training. Attendees have repeatedly rated this training as highly satisfied, and report this as a means of building both skill and confidence in having the serious illness conversation.
The link to the website with the palliative care training information and videos of an ideal and not so ideal conversation is https://www.miccsi.org/palliative-care-training-resources/.
Coming in 2024:
If you have any questions regarding the “Advanced Engagement” training or any other trainings, please contact Sue Vos via email at sue.vos@miccsi.org or phone at 616.292.5774.
Palliative Care
About these courses:
This training will create a foundation for introducing palliative care into the primary care setting earlier in the course of a serious illness. Multiple training sessions have been created and are available to any physician or care team member who would like to attend. There is no cost to these trainings. The training opportunities are:
Palliative Care – Spiritual, Religious and Existential Aspects of Care
December 4, 2023 9:00am-11:00am
This two-hour course will discuss the definitions and importance of spirituality, religion, and existentialism in the care of patients with serious illness and at the end of life. This course will provide information on assessment tools and conceptual models of practice. Register here: https://transformcoach.wufoo.com/forms/rer7y5t0d6hyay/
Please join us for a
FREE Advance Care Planning Community Facilitator Training
Nursing and Social Work continuing education credits (CNEs) available
Wednesday November 15, 2023
8:30 a.m. – 12:30 p.m.
The training is in-person with a virtual option. Participants will either be
emailed a link to the in-person location or virtual training upon registration.
Prework will be emailed to the participant at course sign-up. Pre-work
and participation in role plays are expected for this course.
Virtual attendees must have a working camera and microphone
Or ability to call in, as active participation is needed.
MyMichigan Medical Center Midland is an approved provider with the Michigan Social Work Continuing Education Collaborative. Approved Provider Number: MICEC-0043. Four Social Work CEUs are available upon successful completion of this four-hour program.
MyMichigan Health is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. Three and a half contact hours are available upon successful completion of this four-hour program. In order to receive contact hours for this activity, you must stay for 90 percent of the course and complete an evaluation.
MyMichigan: Advance Care Flyer November 2023
Please register by Wednesday November 8, 2023 by contacting
Amy Bailey at amy.bailey@mymichigan.org or Kelly Perry at kelly.perry@mymichigan.org
Integrated Health Partners (IHP)
IHP offers an array of trainings throughout the year. This includes Introduction to Team Based Care, Patient Engagement, and Foundational Care Management Codes and Billing Opportunities. Each event is listed below along with upcoming dates and the event registration link.
| Intro to Team Based Care
8:30 a.m. – 5:00 p.m. |
Patient Engagement
8:30 a.m. – 5:00 p.m. |
Foundational CM Codes and Billing Opp.
Times vary; see below |
| Wednesday – 1/10/2024 | Tuesday – 1/30/2024 | Tuesday – 1/23/2024; 9:00 a.m. –2:00 p.m. |
| Tuesday – 2/6/2024 | Thursday – 2/22/2024 | Wednesday – 2/21/2024; 11:00 a.m. – 4:00 p.m. |
| Wednesday – 3/27/2024 | Monday – 3/4/2024 | Tuesday – 4/30/2024; 9:00 a.m. – 2:00 p.m. |
| Thursday – 4/4/2024 | Wednesday – 4/24/2024 | Wednesday – 5/8/2024; 11:00 a.m. – 4:00 p.m. |
| Monday – 5/6/2024 | Thursday – 5/2/2024 | Wednesday – 7/24/2024; 9:00 a.m. – 2:00 p.m. |
| Wednesday – 6/19/2024 | Wednesday – 6/12/2024 | Wednesday – 8/28/2024; 11:00 a.m. – 4:00 p.m. |
| Tuesday – 9/24/2024 | Wednesday – 9/11/2024 | Tuesday – 10/22/2024; 9:00 a.m. – 2:00 p.m. |
| Wednesday – 10/9/2024 | Monday – 10/7/2024 | Monday – 11/4/2024; 11:00 a.m. – 4:00 p.m. |
| Tuesday – 11/12/2024 | Wednesday – 11/6/2024 | |
| REGISTER HERE | REGISTER HERE | REGISTER HERE |
If you have any questions, please reach out to Amber Jackson at jacksona@integratedhealthpartners.net.
Documentation is an important element of clinical care, but often can feel overwhelming. In a three-part series, the experts at AAFP have created a toolkit to ease common practice pain points. Part One focuses contains a toolkit with discrete ideas about reducing documentation burden through techniques, technology, and practice transformation tips for improving daily life your practice.
Michigan Multipayer Initiatives 