Michigan's expansion of its Medicaid program has paid off and helped expand access to health care for hundreds of thousands of its residents, according to two new reports.

Michigan expanded its Medicaid program, also known as its "Healthy Michigan Plan," in 2013 to extend health care services to more low-income Michigan residents who were uninsured or underinsured. The plan primarily focuses on primary and preventive care, encouraging patients to complete a healthy risk assessment and discuss their health behaviors with a primary care provider within three months of enrollment. As of Dec. 9, the program has more than 651,000 enrollees, according to the Michigan Department of Health & Human Services.

To assess the expansion's impact, several members of the Healthy Michigan Plan evaluation team from the University of Michigan examined how access to and receipt of care – particularly primary care and preventive services – as well as enrollees' experiences with the risk assessments and engagement in healthy behaviors changed before and after the plan went into effect. They conducted nearly 4,100 telephone surveys on both issues in 2016 among people ages 19 through 64 who had been enrolled in the program for more than a year.

The results of the first paper found "substantial increases in having a regular source of care," including primary care, health counseling and other services, such as cancer screenings; reported improvements in overall physical, mental and dental health; and high use of preventive services. It also noted that the percentage of enrollees who saw a primary care physician after enrolling in the program doubled.

“Customizing Medicaid expansion to emphasize primary care and prevention took extra effort, but appears successful, at least according to the snapshot of enrollees that these data represent,” Dr. Susan Dorr Goold, professor of internal medicine at the university and the lead author of one of the two papers, said in a statement.

The second study on health risk assessments as well as discussions and adaptions of healthy behaviors found high levels of self-reported assessment completion, with nearly half of all enrollees reportedly answering the questionnaires. The researchers also found that about 80% of those who completed the assessments reportedly committed to work on at least one health behavior, with the encouragement of their primary care providers.

"The role of primary care providers, and their teams, in helping low-income and working-poor people understand what health risks they face, and encouraging them to modify the risk factors they can change, is crucial,” Dr. Renuka Tipirneni, an assistant professor of internal medicine and senior author of the second paper, said in the statement.