Laura Summers is the senior health care analyst at the Kem C. Gardner Policy Institute at the University of Utah. She focuses on conducting research on health care data and health policy outcomes in Utah. Prior to Kem C. Gardner, she was senior director of state intelligence at Leavitt Partners.
In this Q&A, Summers discusses the most important policy conversations heading into 2022 including Medicaid enrollment concerns, behavioral health, and COVID-19.
State of Reform: What do you think is the biggest thing happening right now in health care and health policy in Utah? What are you focusing your mental energy on?
Laura Summers: “The easy answer is obviously COVID-19 as the cases continue to rise and our hospitals continue to be full. I don’t think we’ve quite seen what the outcomes are with the emergence of the Omicron variant. So in terms of health care, I think that’s going to take precedence for the next two to six months as we continue to see what the outcomes of this particular case surge is going to be.”
SOR: What other health policy issues in Utah should we be expecting in 2022?
LS: “I think a couple of the big ones are related to COVID-19. The industry is continuing to struggle with workforce concerns. Many areas in Utah are Health Professional Shortage Areas. The effects of COVID-19 have really exacerbated that in the state of Utah. I think you hear anecdotally, as well as a little bit in the data, about the number of people who are leaving the health care industry, switching sub sectors, or switching occupations within the industry. That is putting a strain on the health care workforce in general. In the next six months, we’re going to have some good data on what the great resignation has meant for Utah’s health care workforce.”
SOR: What are you expecting to be the most important piece of legislation in this upcoming session?
LS: “I think anything related to COVID-19, its public health impacts, and how relief funds are spent will be driving issues for the state. I am expecting—and hoping—for there to be some legislation around behavioral health. Over the last couple of sessions, there was a really strong focus from the legislature and different organizations pushing to improve Utah’s behavioral health system.
A lot of work has gone into making behavioral health improvements, but more work needs to be done. Another fallout from the pandemic is the increasing behavioral health needs, increasing mental health needs among adults, as well as increasing mental health needs among Utah’s children and youth as well. Therefore, I am expecting there to be some behavioral health related legislation as the state continues to think about how to address mental health needs, how to address substance use disorder needs, and improving the entire system.”
SOR: What are you expecting to see in terms of policy implications or changes in Utah’s Medicaid?
LS: “We fully expanded Medicaid in January 2020. Since it was right before the pandemic hit, it’s going to be really interesting to see what the Medicaid population looks like. Certainly it’s grown as a result of the effects of the pandemic. I think we’ve seen more people going on Medicaid as a result of the expansion and potentially as a result of the impacts of COVID-19 on the economy. However, because of the federal regulations surrounding the public health emergency, people can stay on Medicaid and are not being bumped off due to eligibility determination changes. So, I don’t think we have quite a full picture of what Utah’s Medicaid expansion population will look like long term yet.
I also don’t think we have a good sense of what Utah’s uninsured population is going to look like post-expansion, because once the public health emergency ends and those federal regulatory rules and regulations change, we go back to the typical eligibility determination process. It’s going to be interesting to see [how the legislature will determine] what policies are needed to address those individuals who are still uninsured at that point.”
SOR: What do you think is the future of the Utah Medicaid Integrated Care programs and how does that fit into the larger narrative of behavioral health reform?
LS: “They were testing out this integrated physical and behavioral health plan where the ACOs (Accountable Care Organizations) were delivering both the physical as well as the behavioral health services. Before, they were split, where the physical or the medical health services ran through the ACOs, and the behavioral and mental health services ran through the counties. It started with this first step to integrate those plans.
In terms of moving forward, I know they’re in the process of getting the first year data from those plans. I think it’s going to be really interesting because I think this is part of the bigger need in the state of Utah to address and integrate physical and behavioral health needs. We know from the research that those needs are so integrated. [If quality outcomes come out of the first year of data], then the state can take that data and make changes or revisions as needed to impact policy change.”
SOR: What gives you hope in terms of health care policy in Utah?
LS: “Across so many different levels, whether we’re talking about COVID-19, behavioral health, or workforce issues, I was continually impressed by our legislators, our policymakers, our health care system leaders and their desire to make the system better and make good and sound policy changes.
The thing that gives me the hope is that the people in charge are coming from a place of wanting to make the system better and insist on working collaboratively to make the system better. I think you see that really strongly in the state of Utah and we’ve seen some really positive outcomes as a result of that.”
This interview was edited for clarity and length.