NJ’s Approach to Medicaid ACOs

An Experiment Worth Watching

StatehouseIn July 2015, New Jersey certified three applicants for the New Jersey Medicaid Accountable Care Organization (ACOs) Demonstration Project.

The HealthAffairsBlog’s Joan Randall reported that they are the Camden Coalition of Healthcare Providers, the Healthy Greater Newark ACO, and the Trenton Health Team.

New Jersey ACOs were authorized in 2011 when Governor Chris Christie signed ACO legislation.

‘This approach grew out of work by Dr. Jeffrey Brenner and the Camden Coalition of Healthcare Providers, famously chronicled in Atul Gawande’s 2011 The New Yorker article, ‘The Hot Spotters.’ Brenner and his colleagues analyzed local hospital claims data and discovered that a small percentage of patients were responsible for a substantial proportion of hospital costs. These findings were a wake-up call for the need to implement a new model of health care delivery for the state’s Medicaid enrollees. Subsequent advocacy by Brenner and other stakeholders led to the 2011 legislation.”

“How these three community coalitions fare in the three-year demonstration project bears watching for two reasons. One is that their community-based approach offers an exciting new model for providing care to Medicaid recipients. This approach can be seen in the geography, composition, and governance structure.’

The second reason to pay attention to this Medicaid demonstration project is its potential to align quality objectives with payment incentives.”

Randall writes.

In New Jersey, ACOs and work in partnership with Medicaid Managed Care Organizations (MMCOs) by “delivering better health care to New Jersey’s most vulnerable citizens and saving money by keeping them out of the hospital.” And MMCOs can assist ACOs in doing their job.

Click here for the full HealthAffairsBlog post.