Public worker unions will advocate for New Jersey to test out ‘patient-centered’ approaches to health care they say would save taxpayers money by improving care for chronic conditions.
By Michael Symons
TRENTON, NJ | FEBRUARY 12, 2015 – Union representatives say it’s possible to provide public workers better health care and save money for taxpayers, and they hope Gov. Chris Christie‘s administration will go along with an experiment.
“Patient-centered health care” options similar to those used by Vermont and some private-sector providers can cut costs by paying doctors based on patient outcomes, not for procedures, according to Senate President Stephen Sweeney and labor and health-care advocates who joined him at a Statehouse news conference Thursday. Those savings could be around 15 percent, according to boosters for the approach.
“Workers are coming to the table, willing to explore a new concept of health care that will save taxpayers money,” Sweeney said. “The only thing the administration ever says is, ‘We’ve got to cut their benefits.’ There is enormous cost when you cut benefits. People don’t care the care they need, and when they don’t get the care they need it costs more.”
Development of a “patient-centered” option wouldn’t require action by the Legislature. It would require cooperation from Christie, as the State Health Benefits Program plan design committees that would develop the options are equally divided between labor and administration representatives.
Christie spokesman Michael Drewniak said the administration had no comment on the proposal.
Here’s an overview of the concept:
• Participation would be voluntary for both doctors and patients.
• There would be five small networks of clinical locations in the pilot program, in areas with concentrations of public workers. One would be in the Trenton area. There would be two in North Jersey and two in South Jersey.
• The pilot program would include up to 60,000 public employees and their families, a sliver of the state health plan’s 800,000 members.
• Patients would have guaranteed same-day or next-day appointments for urgent care and wouldn’t pay out-of-pocket fees or deductibles when visiting their primary doctor.
• Doctors’ practices would be limited to 1,000 patients, rather than the 2,500 to 3,000 many have currently. They’d be paid a set monthly amount for their services and could earn bonuses for meeting goals for managing chronic care. Earnings would no longer be linked to their number of patients or procedures.
Doctors from two physician groups, which together include more than 2,500 doctors, joined Sweeney at the news conference to support the concept.
“My patient panel is about 2,500 or 3,000 patients, something like that. I can’t tell you how exciting that is to me as a physician to hear about a patient panel of a thousand,” said Dr. James Holton, who practices in Medford. “To me, that’s VIP medicine. That’s concierge medicine.”
“We’re not treating diseases. We’re not treating members. We’re not treating numbers. We’re treating people, and these people have concerns, fears, cultures, beliefs, financial, social situations that impact their health,” said Dr. James Barr, who practices in Neshanic Station. “And if we don’t learn that, if we don’t have relationships with them, we’re never going to be able to help them at the degree that we need to.”
The State Health Benefit Program has offered a patient-centered, managed-care model through Horizon Blue Cross Blue Shield since 2012 that includes more than 900 locations and 6,000 doctors statewide, said Treasury Department spokesman Chris Santarelli. The state says it will yield annual net savings of $20 million.
In the 2014 state budget, New Jersey spent $2.8 billion on health benefits for current workers and retirees. Those costs are projected to reach $6 billion, or 14 percent of state revenues, by 2023. Recommendations for addressing that cost are expected soon from a commission appointed by Christie. A state law enacted in 2011 requires workers to pay more toward their health coverage, but the governor is advocating additional changes.
“Those of us on the labor side refuse to allow our members to be burdened with higher and higher costs each year for lower quality benefits. They’ve sacrificed a lot in the last few years, and it has to stop,” said Sean Spiller of the New Jersey Education Association. “But we also know that employers, whether at the state level or the local level, cannot keep absorbing health care costs that rise faster than inflation. Over the long term, we know that’s not sustainable either.”
Mark Blum, executive director of a nonprofit coalition of labor, business, health care and government officials called America’s Agenda, said health care costs are growing four times faster than wages and that the gap is even worse in New Jersey.
“The good news is when you have a health system that’s delivering from a cost perspective health care so inefficiently, there’s enormous possibilities for savings,” Blum said.