NJ Spotlight on Cities: How Garden State Can Achieve ‘Integrated’ Healthcare

Lilo H. Stainton | October 11, 2016 | Health Care
Can ‘integrated care' deliver on its promise of better patient outcomes and better bottom line?

On Cities Healthcare
Integrating physical and behavioral care can improve health outcomes for patients and greatly reduce costs over time, research has proven.

On Friday, October 14, a panel of experts with diverse experience in New Jersey’s healthcare system will join the NJ Spotlight on Cities conference to discuss how the Garden State is doing when it comes to integrated care.

The panel includes Sen. Joseph Vitale (D-Middlesex), longtime chair of the Senate health committee; Carolyn Beauchamp, president and CEO of the Mental Health Association in New Jersey; Greg Paulson, executive director of the Trenton Health Team; and Barbara Mintz, vice-president for wellness at RWJ/Barnabas.

A report released in March by researchers at Seton Hall University found that despite a number of recent efforts by state regulators to improve coordination between behavioral and physical care providers, significant regulatory and systemic hurdles remain. The issue is particularly important for New Jersey’s urban areas, which are home to some of the state’s most chronically ill individuals.

At Friday’s conference, to be held at the New Jersey Performing Arts Center, in Newark, Beauchamp of the MHAINJ will discuss what she’s learned from three decades of advocacy for those who struggle with behavioral health issues. (Patients with serious mental illness die an average of a quarter-century earlier than those without, studies have shown, largely because they have chronic diseases that don’t get properly treated.)

Paulson, with the Trenton Health Team, will talk about how hospitals, doctors, clinics, and community groups are knitting together a more comprehensive system of care in the capital city. His group received $1 million in state funding last year to help expand its work as an Accountable Care Organization.

Mintz, from RWJ/Barnabas, will share what’s worked in Newark, New Jersey’s largest urban area, and how community programs can help connect residents with healthcare. She will also discuss the importance of focusing on prevention and wellness as part of a comprehensive approach to improving care; this approach can keep patients healthier and save money as they face fewer costly chronic diseases in the long run.

Sen. Vitale, the architect of New Jersey’s nationally recognized FamilyCare program, has led a number of reforms to expand access and improve the quality of care, especially for low-income residents. His district, in Middlesex County, includes several urban hubs — including Perth Amboy and New Brunswick — that present unique healthcare challenges, and opportunities.

Vitale will talk about legislation (S-1710) he has sponsored that would help better integrate care for millions of patients across the state. The bill calls on the two state agencies that oversee health facility licensing — the Department of Health, which regulates the majority of healthcare operations, and the Department of Human Services, which is responsible for coordinating most behavioral healthcare programs — to build a unified licensing process for doctors, clinics, and other non-hospital providers who want to offer both physical and behavioral treatments at the same site. Under the current system, this could require separate approvals.

The healthcare panel begins at 11:30 am. Tickets for the conference are still available.

While authors of the Seton Hall report praised the efforts of workers in both the DOH and DHS, they said the current system creates a serious problem for poor patients who suffer from complex, multidimensional conditions.

Those with serious mental illness tend to receive care from mental health clinics — primarily state-funded nonprofit operations — that aren’t usually equipped to treat their physical conditions, like diabetes or hypertension. And patients burdened in large part by physical concerns tend to go to medical clinics, like the 23 Federally Qualified Health Centers with sites around the state. While these providers can treat acute and chronic conditions, few are set up to provide ongoing behavioral healthcare.

In addition to better coordination among staff at the DHS and DOH, the Seton Hall report recommended changes to how doctors and other providers are paid through Medicaid — including increases to the rates at which they are reimbursed for their services. Gov. Chris Christie has committed $127 million more in the current budget for behavioral health reimbursements, but providers have said that other reforms have triggered significant concerns about their financial stability long-term.