New Jersey

In September, 2010 a state law (NJ P.L. 2010, Chapter 74) was passed directing Medicaid to establish a three-year pilot demonstration for medical homes focusing on the frail elderly and those with chronic diseases. In response to the legislation, the Department of Human Services, Division of Medical Assistance and Health Services (DMAHS) entered into a Memorandum of Agreement (MOA) with the four Medicaid contracted managed care organizations (MCOs) in NJ to participate in a pilot to enhance or create infrastructure, within their networks, for medical home services. Three of these MCOs are also participating in the statewide Comprehensive Primary Care (CPC) initiative in New Jersey.

New Jersey has two publicly funded Behavioral Health Home programs and a privately funded primary care/behavioral health care project. New Jersey is currently working on the development of a Medicaid Health Homes program based on the experiences with these programs that will focus on individuals with behavioral health care needs. 
 

CHIPRA: 
No
MAPCP: 
No
Dual Eligible: 
No
2703 Health Home: 
Yes
CPCi: 
Yes
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
8,849,300
Uninsured Population:
12%
Total Medicaid Spending FY 2013: 
$10.6 Billion 
Overweight/Obese Adults:
62.8%
Poor Mental Health among Adults: 
31.3%
Medicaid Expansion: 
Yes 
CPC+: 
CPC+

Medical homes, ACOs offer better business models

The patient-centered medical home model in Arkansas, which has more than 600 participating providers, helps the state's Medicaid program incentivize quality care instead of paying for volume of services. Arkansas officials designed the PCMH payment structure to support primary care doctors in the state, who often rely on high volumes of acute care, to instead implement team-based strategies, coordinate chronic care delivery and achieve better patient outcomes, according to a He

News Author: 
Dina Overland

Patient-Centered Medical Home Evaluations: Let’s Keep Them All In Context

Since the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), American College of Physicians (ACP) and American Osteopathic Association (AOA) issued their Joint Principles of the Patient-Centered Medical Home in 2007, there has been an explosion in medical home transformation activity in the United States.  According to the National Committee for Quality Assurance(NCQA), which offers one of multiple medical home recognition programs in the U.S., 5,739 practices representing 27,820 clinicians had received NCQA medical home recognition status as of May 2013.

News Author: 
Chris Arenson, MD Eric Berman, DO Allan Crimm, MD Susan Day, MD Trudi Haecker, MD Don Liss, MD Nancy Meisinger Linda Siminerio, RN, PhD Linda Thomas, MD Bill Warning, MD Auren Weinberg, MD

Horizon Blue Cross Blue Shield of New Jersey - Accountable Care Organization Initiatives

Horizon Blue Cross Blue Shield of New Jersey is transforming and improving New Jersey’s health care delivery system by collaborating and developing solutions to create a health care system marked by high-quality care, a better patient experience and improved affordability.

Horizon Blue Cross Blue Shield of New Jersey’s Patient-Centered Pediatric Program

Horizon Blue Cross Blue Shield of New Jersey is transforming and improving New Jersey’s health care delivery system by collaborating and developing solutions to create a health care system marked by high-quality care, a better patient experience and improved affordability.

On the "Front Lines" of Health Reform: Reinventing Team-Based Care

With millions more Americans now eligible for health insurance coverage, health care organizations and providers throughout the U.S. are experiencing increasing pressure to balance the growing demand for health care services. At the same time, providers are being asked to improve quality and lower costs.

News Author: 
Kavita Patel, Jeffrey Nadel

New Report Finds Medical Homes Are Reducing Health Care Costs, Utilization, and Improving Health

A review of the year’s academic and industry-generated PCMH evaluations finds significant impact across a number of clinical and financial outcomes.

Embargoed Until Monday, January 13th, 4PM

PCPCC: Michelle Shaljian, 347-754-1692, michelle@pcpcc.net

Milbank: Tara Strome, 212-355-8400, tstrome@milbank.org

New Report Finds Medical Homes Are Reducing Health Care Costs, Utilization, and Improving Health

Horizon BCBSNJ Launches Patient-Centered Pediatric Program that Puts Focus on Improving the Health of Children and Families

Horizon BCBSNJ announces first patient-centered program dedicated to pediatric care.

Horizon Blue Cross Blue Shield of New Jersey announced today that it is launching a new, family-focused program to improve the health of children. This is Horizon BCBSNJ’s first patient-centered program dedicated to pediatric care.

Horizon BCBSNJ’s new Patient-Centered Pediatric Program will initially benefit more than 100,000 pediatric members. More than 630 pediatricians and family practice doctors at over 110 practice locations throughout New Jersey will be participating in Horizon’s newest value-based initiative, which launches on January 1, 2014.

Horizon Blue Cross Blue Shield of New Jersey Works With Monmouth County to Improve the Quality and Delivery of Care for County Workforce

New results show that Monmouth County public employees are benefitting from a new wellness initiative designed by Horizon Blue Cross Blue Shield of New Jersey. County employees who used physicians in Horizon BCBSNJ’s Patient-Centered Medical Home (PCMH) program showed a significant increase in preventive screenings, one of the goals of the program.

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