Assessing the Effectiveness of Policies to Improve Access to Primary Care for Underserved Populations, Case Study Analysis: Detroit, Michigan

Abstract

This case study of Detroit, Michigan, the fourth in a series, assesses the effectiveness of various policy initiatives to expand access to primary care in the region, particularly for underserved populations. Several parts of the city are classified as primary care health professional shortage areas, and many policy initiatives have been implemented to make primary care more accessible, but barriers persist. State and local governments have been proactive in increasing the number of graduate medical education spots in the city, and some of these residents have continued to practice in the area following completion of their training. Despite these efforts, there is still a lack of primary care clinicians serving low-income populations in the city. Federally qualified health centers (FQHCs) and other safety net clinics remain a key source of primary care for low-income populations, but FQHCs in Michigan receive limited state funding. Several interviewees specifically identified lack of access to transportation as a key barrier to accessing primary care in the city. An innovative local mobile health program is taking primary care directly to the communities most impacted by this lack of access to affordable and reliable transportation. Local providers have also taken advantage of federal flexibilities under the COVID-19 public health emergency period to build up their audio-only telehealth capabilities, allowing them to further connect with people in hard-to-reach communities.