State Wants To Know Why Some N.J. Medicaid Patients Cost So Much To Treat
TRENTON – Three health care groups, from Newark, Trenton, and Camden, have been selected by the state to study why some Medicaid patients cost so much money to treat, and how to improve their health by preventing disease and avoiding hospital stays.
Each of these “accountable care organizations,” made up made up of doctors, hospitals, and mental health and social service agencies, will also get a chance to earn additional payments from the managed care companies that provide Medicaid coverage if they bring down costs and show patients are measurably healthier, said Jeff Brown, the executive director of the QI Collaborative, an offshoot of the NJ Health Care Quality Institute.
Those who are frequently in hospitals, known as “superusers,” comprise about 1 percent of the inpatient population and about 30 percent of hospital billings. According to the Camden Coalition, of the 79,000 residents in the city, 386 patients accounted for the top 1 percent of emergency department visitors in 2011.
The Nicholson Foundation awarded $10 million to enable the organizations to develop the plans and implement them, according to Joan Randell, the chief operating officer. The foundation will make more money available to allow the organizations to grow, she said.
Randell congratulated the Trenton Health Team, the Healthy Greater Newark ACO, and the Camden Coalition of Healthcare Providers for being selected on “what surely will be a complicated journey to improve health care access and quality.”
“They will learn what works, modify what doesn’t, and spread” the successful strategies with each other and across the state, she added.
About the Trenton Health Team
Trenton Health Team (THT) is an alliance of the city’s major providers of healthcare services including Capital Health, St. Francis Medical Center, Henry J. Austin Health Center and the city’s Health Department. In collaboration with residents and the city’s active social services network, THT is developing an integrated healthcare delivery system to transform the city’s fragmented primary care system and restore health to the city. THT aims to make Trenton the healthiest city in the state. Support for the Trenton Health Team was provided in part by a grant from The Nicholson Foundation. For more information, visit www.trentonhealthteam.org.