The Transformative Impact of New Jersey’s Medicaid Accountable Care Organizations

New Jersey's 3 Medicaid ACOs (Camden, Trenton, & Newark)

Thomas Edison University  |  Trenton, NJ

Thursday March 23

Last Thursday, on the 7th anniversary of the Affordable Care Act (ACA), community leaders highlighted the promise of local models. A Medicaid Accountable Care Organization (ACO) is an evidenced-based model that aims to improve outcomes for individuals with complex health and social needs by improving the coordination and delivery of their care. The Good Care Collaborative convened providers, advocates, and policy leaders for a forum to discuss early impact and future implications of New Jersey’s community-based Medicaid Accountable Care Organizations.

Leaders from across the state shared lessons learned and discussed how this work can continue to reshape New Jersey’s health care landscape. With limited resources and increasing uncertainty at the federal level regarding the future of Medicaid, the Medicaid ACOs provide innovative, evidence based, regional approaches to improving quality, outcomes and efficiencies for vulnerable patients.

Victor Murray, Director of Population Health Initiatives at the Camden Coalition, discussed some of their preliminary findings, saying, “Our work is impacting patients and providers on the ground every day and we are beginning to see a positive savings trend for our ACO, despite significant increases in pharmacy, outpatient and pediatric care costs across the state.” In addition, Camden is excited about behavioral health strategies, including developing more capacity and access to local suboxone licensed providers.

“Medicaid touches one out of every five lives in our state’” said Linda Schwimmer, President and CEO of New Jersey Health Care Quality Institute, which recently published a report entitled Medicaid 2.0, which calls for an evolution of the ACO model to better reflect the work these groups are already doing. “The [Medicaid] program accounts for approximately 20 percent of New Jersey’s state budget. Modernizing Medicaid and making the program more efficient and effective will be essential to future generations and to the fiscal stability of our state for years and decades to come.”

The event also highlighted a “Social ACO” in Massachusetts, developed by the Commonwealth Care Alliance (CCA). Lori Tishler, Vice President of Medical Affairs, discussed a fully integrated financing structure of a holistic, comprehensive program that has the capacity and resources to address the social needs of their patients.

“New Jersey’s Medicaid ACOs have brought competing stakeholders together, around a shared vision that was spurred by the State’s Demonstration Project,” said Gregory Paulson, Executive Director of Trenton Health Team. “We have developed the partnerships and infrastructure to advance this work in significant ways. But there’s a lot more work to be done. Continued structural and financial resources are needed to advance our regional collaboration and coordination and to complete the Demonstration Project with integrity.”

 

Speakers:

Shabnam Salih, Camden Coalition of Healthcare Providers
Derek DeLia, Rutgers Center for State Health Policy
Jim Lloyd, Center for Health Care Strategies, Inc.
Victor Murray, Camden Coalition of Healthcare Providers
Gina Mumolie, Trenton Health Team, Capital Health
Kim Barnes, Lourdes Health System
Janel Winter, Department of Community Affairs
Linda Schwimmer, New Jersey Health Care Quality Institute
Lori Tishler, Commonwealth Care Alliance
Colleen Woods, Healthy Greater Newark ACO
Greg Paulson, Trenton Health Team
Edie Calamia, UnitedHealthcare
Natassia Rozario, Camden Coalition of Healthcare Providers

 

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Published on February 14th, 2017