Tens of thousands of public workers in New Jersey now have another option when it comes to patient-focused healthcare, thanks to a growing program developed by Senate President Steve Sweeney and labor unions to improve treatment options and curb taxpayer costs.
Paladina Health, a for-profit company that is a national leader in patient-centered care, opened its first Garden State facility in June as part of the state’s direct primary-care program. The Hamilton office is open to many state workers and public school employees — and family members of all ages — and treatment is paid for through their existing health insurance policies, with no out-of-pocket charge to patients.
Because Paladina primary-care physicians treat 70 percent fewer patients than doctors on average, they are able to spend far more time with each individual, be more accessible between appointments, and serve as coordinators for all medical treatments. This model has been shown to reduce patient hospitalizations, surgeries, and specialist visits while holding down the overall cost of care.
Paladina, now at work in 11 states, plans to open another location this fall in North Jersey. The company joins the R-Health Direct Primary Care Program, which operates clinics in Burlington, Camden, and Mercer counties that also serve the Garden State’s public workers through the same initiative. In both practices, physicians are paid a salary to care for a set amount of patients, not reimbursed based on the type or quantity of treatments they provide.
Cutting healthcare costs
Sweeney (D-Gloucester) has said the program could eventually cover some 60,000 of the state’s 700,000 school and government employees; the state budgeted some $3.7 billion on healthcare for these workers last year. Other systems that implemented these programs have seen healthcare costs decline from 5 percent to 15 percent annually, he predicted.
The direct-care program is one of several reforms Sweeney outlined in 2015 to reduce costs for the State Health Benefits Plan, which insures state workers, and plans that cover teachers, county, and municipal workers — all funded largely by taxpayers. Earlier this week his office announced the state had hired Truvaris, a national company that has developed systems to save significantly on prescription drug costs, a move anticipated to cut New Jersey’s drug budget by $1.5 billion over the next three years.
“The rising cost of healthcare in New Jersey is one of the most critical public policy issues we face,” Sweeney said in 2015.
Welcome to New Jersey
On Wednesday, the Senate president also congratulated Paladina on its opening and welcomed them to New Jersey. “Their model reflects the ‘quality of service’ vision that’s behind the Patient Centered Healthcare initiative I created in the Senate,” he said. “By focusing on patient outcomes instead of fee-for-service, we can keep people healthy and out of the doctor’s office.”
The facility’s opening was also welcomed by leaders from the Communications Workers of America, American Federation of Teachers, and New Jersey Education Association — powerful unions that played a key role in Sweeney’s Plan Design Committee, which hashed out the details of the reforms. State Sen. Linda Greenstein (D-Mercer) and Assemblyman Daniel Benson (D-Mercer), who represent Hamilton, also heralded the new clinic.
Paladina’s Hamilton facility can provide primary and preventative care, including pediatrics, as well as urgent care treatments and coordination with external specialists and hospitals, the company said; it also offers fitness and nutrition coaching. Because it’s primary-care doctors see fewer patients, wait times are generally four minutes, appointments can last 30 minutes to 45 minutes, and physicians are accessible 24/7 by telephone.
No extra charges
Unlike at most facilities, patients at Paladina pay no co-pay or other additional charges, beyond their normal plan premium. According to the company, more than 95 percent of patients are satisfied or better with their physician under the company and nearly eight in 10 said their health had improved since signing on with Paladina. In addition to a salary, Paladina providers are rewarded financially for keeping patients healthy.
“This launch marks an important, exciting step forward as we work to show New Jersey families just how great primary care can be,” said Dr. Pearl Guerzon, the first Paladina physician in New Jersey. “Everyone deserves high-quality healthcare and easy access to a doctor who truly cares about their wellbeing and has time to care for their needs. I consider it a privilege to be a family physician. Caring for kids, their parents, and grandparents allows meaningful, trusting relationships to form with all my patients.”
Joining Paladina — or R-Health — does not require a change of insurance policy, but may require patients to designate a new primary-care provider. For more information, including eligibility details and to sign up, visit Paladina’s website.