The List: NJ Hospitals with the Most Commercially Insured Patients

Andrew Kitchenman | November 23, 2015 | The List
In healthcare finances, wealthier ‘payer mix’ is a key to hospitals’ stability

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Some New Jersey hospitals face a constant fiscal challenge as they provide care to a high number of patients who are uninsured or are covered through the lower-paying Medicaid program.

On the other end of the spectrum, however, are those that thrive financially, thanks to a large number of patients who have commercial health insurance.

Statewide, only 33.6 percent of admitted patients are insured through commercial plans – typically through their employer, although a rising number of New Jerseyans have commercial insurance through the federal marketplace.

In addition, also statewide, 39.9 percent of hospital admissions are insured through Medicare, 15.9 percent through Medicaid, and 10.9 percent through other means – included those whose hospital stays are reimbursed through charity care.

The hospitals below are ranked based on the share of patients admitted who have commercial insurance. They tend to be located in or near wealthier areas. They are the other extreme of an article NJ Spotlight published in June listing hospitals with the most uninsured and Medicaid patients.

This list was assembled from 2013 data complied by Minnesota-based healthcare analyst and consultant Allan Baumgarten and published by the Plainsboro-based Robert Wood Johnson Foundation.

1. Englewood Hospital and Medical Center, 59.5 percent

Drawing patients from the relatively wealthy towns in northeast Bergen County, Englewood remains independent. Its payer mix also includes 25.7 percent of patients with Medicare.

2. Virtua-Memorial Hospital of Burlington County, Mount Holly, 56.9 percent

While Mount Holly itself isn’t wealthy, the communities that surround it have a low rate of uninsured residents. It’s part of the four-hospital Virtua system, which has the second highest-share of commercially insured patients of any system in the state, at 43 percent.

3. Saint Barnabas Medical Center, Livingston, 53.3 percent

This is the flagship of the state’s largest healthcare system – set to become even larger with the proposed merger with the RWJ Health System. It serves wealthier communities in Essex and Morris counties.

4. Saint Peter’s University Hospital, New Brunswick, 51.4 percent

Saint Peter’s is another hospital that benefits from nearby towns that have low rates of uninsured residents. But it has the lowest share of patients with Medicare, at 19.7 percent, and the highest share with Medicaid, at 21.3 percent, of any hospital on this list.

5. Morristown Medical Center, 48.5 percent

It’s the headquarters of Atlantic Health System, the system with the highest share of commercially insured patients statewide, at 46.1 percent overall. Morristown also has a relatively high share of Medicare recipients and a low share of Medicaid patients.

6. Overlook Hospital, Summit, 47.4 percent

Overlook has a payer mix similar to that of its Atlantic Health sister hospital, Morristown Medical Center. It also has the second-highest share of Medicare recipients on this list, at 39 percent.

7. University Medical Center of Princeton at Plainsboro, 46.6 percent

Serving the well-insured Princeton area, this facility is one of four independent hospitals on this list. This may reflect the fact that it is easier for hospitals with high numbers of commercially insured patients to resist pressures to merge with larger systems.

8. The Valley Hospital, Ridgewood, 45.9 percent

If anything, Valley’s payer mix is even stronger than its ranking reflects, since it has the highest share of Medicare patients (generally the second-best paying patients after commercially insured patients), at 47.1 percent, and the lowest share of Medicaid patients, at 2.3 percent, on this list.

9. Capital Health System at Hopewell, 44.6 percent

The two-hospital Capital Health System maintains a trauma center at its Trenton location, but most Capital Health inpatient services are concentrated at the new Hopewell facility.

10. Hackensack University Medical Center, 43.3 percent

The state’s largest single hospital, Hackensack serves a diverse population in southern Bergen County. While it has a healthy payer mix, it also serves a significant number of Medicaid recipients, at 13.4 percent.

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