“When patients have to be billed for services that are related to lack of insurance or financial needs, this places an ethical burden on the clinician to determine best practices. Families should never have to choose between seeking social support and paying for care.” 

~Tany Smith (Social Worker MSW Senior) 

Background

Last spring, social workers, employed under the University of Michigan Medical Group (UMMG), were told that their overwhelming performance metrics would increase.  These metrics are tied to insurance billing codes and failure to keep pace could lead to termination. Since their implementation, some of our members have been placed on performance improvement plans, jeopardizing their employment.  

Productivity metrics linked to insurance billing is leading to a crisis in quality patient care and burnout amongst healthcare providers.  Members, in the UMMAP Behavioral Health Unit (primarily Social Workers and Dietitians), responded by organizing.  Approaching their management, they raised concerns over unsafe working and care conditions created by these punitive metrics.

One supervisor resigned her position rather than force her social workers to attempt to meet untenable metrics. In a resignation letter to her supervisors, she wrote:

“I pushed back for many weeks against this plan…  I was mandated to do this for my staff and given a deadline by the end of July. There was even.. an email sent to C&W (Mott) leadership under UMMG (University of Michigan Medical Group) to ensure that I would do this by July 25.  I held this meeting with my team and told them not only would I put staff not meeting the metrics on a pip (performance improvement plan) but that the baseline of the metric was increasing. This meeting was mandated to be a verbal warning to staff giving them 60 days to meet this new bottom line.”

~ Nora Rosenblum (former Mott Social Work Supervisor)

In response, management attempted to discredit this supervisor, claiming she made up the unrealistic metrics. After she left the health system, the increased metrics were enforced.  

Demand to Bargain

In January, the UMMAP Behavioral Health unit sent an open letter to the President of the University of Michigan Health, Dr. David Miller.  Nearly 200 UMMAP members signed the letter, requesting to meet with UMMG leaders to stop using punitive measures.  

Our UMMG Pressure Campaign Committee has met with the Michigan Medicine administration. In each meeting, members shared vulnerable stories about the impact of billing metrics on their work. Our intention was to educate management on the significance of the problem and the reality of metrics. However, our concerns were downplayed and belittled, as if we did not understand billing metrics and the way the health system functions.

Next Steps

We agree increasing patient access to high quality health care is necessary and a high priority. We are all deeply committed to our patients and their care.   However, the UMMG productivity metrics are having the opposite effect, limiting access, especially for our more vulnerable and at-risk patients.  It places unnecessary strain on staff, impacts our personal lives, physical health and mental wellbeing.  During an All Campus Labor Council meeting, we presented pressure campaign, receiving strong solidarity especially from nurses, who face a similar crisis.   

Management hasn’t met with UMMAP representatives since March, despite our repeated requests to meet and to continue negotiating over metrics attached to insurance billing codes.  Management is dragging their feet on this issue. 

UMMAP is proposing a Memorandum of Understanding (MOU) with management to document metrics in a way acceptable to both the workers and management. Currently, over 300 UMMAP Behavioral Health members and 150 UMMAP allies have added their name to support our MOU. To add your name follow this link:  UMMG Pressure Campaign MOU Support petition.

In Solidarity

UMMAP Executive Board

• Penni Toney (CT Technologist) – President
• Cheryl Bodmer (Surgical Technologist) – Vice President
• Amanda Mazzocco (CT Technologist) – Secretary
• Kate Robbins (Physical Therapist) – Treasurer
• Jennifer Kempfer (CT Technologist) – ADEPT Unit Chair
• Courtney Iwanicki (Registered Dietitian) – Behavioral Health Unit Chair
• Kelishia Burks (Medical Assistant Intermediate) – Medical Assistant Unit Chair
• Greg Mannarelli (Audiologist) – Rehabilitation Unit Chair
• Rodney Barber (Histotechnologist) – Laboratory Unit Chair
• Sarah Wilkin (Pharmacy Technician Intermediate) Non-Bargained For Employee Unit Chair