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‘Genius Grant’ Winner Offers Stinging Critique of NJ Healthcare Delivery

During NJ Spotlight conference, Dr. Jeffrey Brenner and others lay out some of the challenges confronting hospitals, doctors and other stakeholders

Jeffery Brenner
Dr. Jeffrey Brenner, executive director of the Camden Coalition.

A New Jersey healthcare landscape with fewer hospitals and less direct interaction between doctors and patients – but one in which more patients receive high quality healthcare – was sketched out by one of the state’s most prominent healthcare leaders at an NJ Spotlight conference late last week.

Keynote speaker Dr. Jeffrey Brenner led the charge into this new world by describing some of the fundamental flaws in the state’s healthcare delivery system, which he believes can be alleviated by adopting a model called accountable care organizations, which emphasize coordination by healthcare providers and pays them more if they actually improve the health outcomes of patients, rather than just paying them for each service they deliver.

Brenner leads the Camden Coalition of Healthcare Providers, which could soon apply to be an ACO for the state’s Medicaid program.

Brenner’s “hot-spotting” work with the organization, which uses patient data to better target healthcare resources – has earned him national recognition. Last year, he was awarded a MacArthur Foundation fellowship, also known as the “genius grant,” for his work.

Brenner laid out the history of ACOs, which grew from research indicating that increasing the amount of healthcare doesn’t necessarily lead to improved health for patients. He noted that New Jersey ranks highest in the country in the amount of care provided– including the number of patients who visit at least 10 specialists – in the last six months and the last two years of life.

“We’re better than anyone else in the country at bouncing our older and sicker and dying patients from doctor to doctor, specialist to specialist, and they get lost in the delivery system,” Brenner told the audience of about 180 gathered for the February 28 event at the RWJ Fitness & Wellness Center in Hamilton Township, Mercer County.

After Brenner spoke, a panel of healthcare experts – including hospital and ACO leaders – sketched out some of the challenges in improving healthcare delivery.

Assemblyman Herb Conaway Jr. (D-Burlington), a doctor, said that access to patient data will be crucial in improving the coordination of care. He expressed disappointment that Gov. Chris Christie didn’t pursue a federal grant to build a database that would include all insurance claims for healthcare services in the state.

Jeffrey Brown, executive director of an ACO trade group -- Affiliated Accountable Care Organizations, an initiative of the New Jersey Health Care Quality Institute -- said ACOs could help correct some of the problems in the U.S. health system.

Brown cited an estimate that the U.S. healthcare spending is larger than the entire Chinese economy, while average health outcomes are similar to those of Cuba.

Dr. Morey Menacker, CEO of the Hackensack Alliance ACO, noted that patients with the financial means come from around the world to avail themselves of American healthcare.

“The system may not be the best system, but the care is the best care available,” Menacker said.

The Hackensack Alliance ACO illustrates some of the promise of the ACO model. It is participating in a Medicare program in which it receives additional payments when it reduces healthcare expenses while also improving patient outcomes. It saved an estimated $10 million in its first year.

Brenner said that one reason for wasteful healthcare spending is the state’s relative wealth, which allows many New Jerseyans to avoid making tough decisions that would help make healthcare delivery more efficient, said Brenner, who is also the medical director for Cooper Health System’s Urban Health Institute.

He noted that two new hospitals that will require additional financial outlay by both taxpayers and patients were recently built in Mercer County -- the University Medical Center of Princeton at Plainsboro and Capital Health Medical Center in Hopewell -- without any public vote on the issue.

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