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Opinion: NJ Must Modernize Medicaid for the Future

Making Medicaid more efficient and effective will be essential to future generations and to the fiscal stability of our state for decades to come

Linda Schwimmer
Linda Schwimmer

Earlier this week, in a crowded room in the New Jersey State House, we unveiled “Medicaid 2.0: A Blueprint for the Future.” The blueprint is the culmination of a year of work that took us around New Jersey — and also to several other states — as we explored ways to make the program more efficient and more effective.

Our goal is to bring New Jersey’s Medicaid program into the future. Medicaid touches one out of every five lives in our state. The program accounts for approximately 20 percent of New Jersey’s budget. Modernizing Medicaid and making the program more efficient and effective will be essential to future generations and to the fiscal stability of our state for years and decades to come.

The 1.8 million New Jerseyans who rely on Medicaid for their health and wellbeing come from every corner of our state. Medicaid beneficiaries make up over 10 percent of the population of all but two New Jersey counties.

The 24 recommendations of the Blueprint are intended to improve the program and enable Medicaid to take advantage of all the advances in the world of healthcare — from new technologies to payment reforms that promote quality and better coordination.

We truly are talking about the future. Over 46 percent of Medicaid enrollees in New Jersey are children. That’s more than 800,000 children. And Medicaid pays for 42 percent of all births in New Jersey. Supporting new approaches to ensure that women have healthy planned pregnancies and healthy births will create healthier citizens and stronger communities.

At the New Jersey Health Care Quality Institute, we know the best way to reduce healthcare costs is to keep people as healthy as possible — and to make sure they receive the right care in the right place.

Medicaid costs federal and state taxpayers over $15 billion annually. Finding more efficient ways to deliver and pay for healthcare will be critical as we enter a time of increasing pressures on the state’s budget.

Medicaid is also critical to the stability of our state’s healthcare industry, New Jersey’s second-largest employer. About half the revenue of safety-net hospitals —and one-fourth of the revenue of all New Jersey hospitals — is connected to Medicaid.

The Blueprint was conceived and funded by The Nicholson Foundation. At our event Monday, Joan Randell, the foundation’s chief operating officer, said Medicaid often has not met the needs of beneficiaries. She talked about how care often is fragmented and said we must integrate physical, behavioral, and health-related needs.

The Blueprint addresses those and other concerns. We did not sit in some tower developing these recommendations in isolation. We had five transformation teams and more than 50 high-level experts who volunteered significant amounts of their time and sought input and perspective from people throughout the state — including families who rely on the program, physicians, nurses, insurers, dentists, social workers, hospital leaders, payers, state administrators, and elected representatives.

We also met with state Medicaid leaders on a regular basis throughout the year. We are grateful for their time and willingness to work with us. They are true professionals who care deeply about this program.

The release of the Blueprint is a milestone, but far from the end of the journey. We will continue working to implement the recommendations over the next 18 months. We now need our current and future state leaders to work collectively to move these recommendations forward to build a stronger Medicaid system for today and for the future.

Linda Schwimmer is the president and CEO of the New Jersey Health Care Quality Institute, a nonprofit focused on improving the quality and affordability of healthcare in the Garden State. She also is a member of the board of the Leapfrog Group, a national hospital-safety advocacy organization that issues the Hospital Safety Score.

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