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Ex-Commissioner Velez Strives to Get Hospitals to Reach Beyond Their Walls

As the mission of hospitals expands and evolves, those changes are reflected even in how they are paid for their services

New Jersey Human Services Commissioner Jennifer Velez.
Credit: NJTV
New Jersey Human Services Commissioner Jennifer Velez

When Barnabas Health hired former state Human Services Commissioner Jennifer Velez earlier this year, it gained a new senior executive, but it also signaled the growing emphasis on improving patient health beyond the hospital walls.

For years, healthcare policy experts have advocated a shift away from just treating illnesses and injuries and toward ensuring that people remain healthy longer.

Velez says this rhetoric is becoming reality.

“It’s the senior who rather than going to the hospital with a hip fracture … instead gets a bar installed in their bathroom” to help prevent injury, Velez said, giving an example of the new approach.

In Velez’s eight years as commissioner she oversaw Medicaid, the largest healthcare-coverage program in the state.

Now, as senior vice president of planning and strategy for Barnabas, she oversees community health assessments and is responsible for identifying growth opportunities.

Hospitals are considering issues like whether people have stable housing and secure access to healthy food, “and whether that can be infused into a prevention model, or a wellness model,” that aims to reduce the number of patients who are admitted into hospitals overnight, Velez said.

Velez discussed the changing healthcare landscape yesterday in a panel discussion with other hospital executives at a New Jersey Business & Industry Association forum in Monroe Township, Middlesex County.

While working in state government, Velez oversaw the ambitious Medicaid comprehensive waiver, which is shifting the focus of long-term care in New Jersey from nursing homes toward home and community-based services. Velez connected the waivers to the broader changes in healthcare that are moving services from facilities to the community, saying that both depend on partnerships among a wide range of organizations to be effective.

Russell Molloy, Meridian Health’s vice president of government relations, said rising healthcare costs have driven providers to look for new ways to provide care. This includes merging with doctors’ offices, which enables hospitals to provide treatment well before patients need to be hospitalized.

He noted that provisions of the Affordable Care Act provide incentives to better coordinate care for Medicare patients through accountable care organizations and other models that pay providers based on keeping patients healthy, rather than the volume of services provided.

State Health Commissioner Mary E. O’Dowd spoke before the panel discussion, describing another example of how payment changes are encouraging hospitals to focus on patient health, the state and federal Delivery System Reform Incentive Program.

In the program, hospitals are paid based on how well they treat a specific illness. O’Dowd said this has spurred hospitals to invest in efforts to prevent potential health problems from escalating. For example, AtlantiCare has used teams of providers to coordinate the care of patients with diabetes to prevent emergency hospitalizations, while Robert Wood Johnson University Hospital in New Brunswick is visiting patients with heart conditions at their homes shortly after they’re discharged from the hospital, working to ensure that they don’t make return visits.

“When you hear about some of the specific work that these hospitals are doing, you’re hearing about social services, which is a little bit different than the inpatient clinical experience,” O’Dowd said.

She said healthcare providers have been frustrated in the past that weren’t paid for providing social services that can make and keep patients healthy. The DSRIP program, O’Dowd said, is a step toward compensating them for these services.

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