New Jersey’s top health industry leaders may disagree on policy issues related to drug pricing and payment models, but they can find plenty in common when it comes to a desire for regulatory stability, a need for innovation, and a willingness to work together to tackle underlying public health concerns, like poor housing and nutrition.
The CEOs of four of the Garden State’s most powerful trade groups — the New Jersey Hospital Association, Medical Society of New Jersey, Association of Health Plans, and Healthcare Institute of New Jersey, which represents the state’s biopharmaceutical and medical technology companies — acknowledged that there are plenty of opportunities to collaborate to improve patient health and their respective industries.
The 2018 New Jersey Health Care Stakeholders Summit, held Friday at the NJHA headquarters in Princeton, was the second-annual joint conference sponsored by the four organizations. It was designed to raise awareness about the challenges they share, and identify opportunities to work effectively together on the state and national level. The event attracted more than 100 healthcare experts and industry insiders.
“All of us up here are here for the benefit of patients,” stressed Dean Paranicas, CEO of the Healthcare Institute, who was joined on an afternoon panel by Cathy Bennett, CEO of the Hospital Association and former state Department of Health commissioner; Larry Downs, CEO of the Medical Society; and Ward Sanders, CEO of the NJAHP. (The author served as moderator for this discussion.)
Dealing with regulatory instability
The leaders of the four highly regulated sectors agreed that one of the most significant current challenges they share is dealing with the political and regulatory instability in Washington, D.C. While federal initiatives like the 2010 Affordable Care Act created new burdens for physicians and required a massive shift in the way care is provided, the CEOs said the potential for major reforms to this and other laws make it very hard for them to plan and invest.
Sanders said this instability has already driven up insurance costs by double digits, and warned that the reforms being discussed for the Medicaid program would inevitably leave New Jersey with less federal funding to cover the more than 1.7 million members now enrolled. Bennett urged federal officials to find a way to coordinate funding for patients who qualify for both Medicare and Medicaid, given the frustrations involved with the current bifurcated system.
Downs said that whatever happens, physicians need a more standardized system of health metrics to track patient gains, and help launching coordinated electronic medical record systems. Paranicas said his members are eager for more predictability related to the federal funding they are slated to receive for drug development, from a fund created by a tax on pharmaceutical companies.
The CEOs are also anticipating changes on the state level, based on new priorities outlined by Gov. Phil Murphy, a Democrat who took office in January – although few details have yet been made available. Downs said physicians are pleased that the state Department of Health will be led by one of their own, Dr. Shereef Elnahal, who will be speaking at an MSNJ event in May.
Encouraged by Elnahal
Bennett said hospitals are encouraged by Elnahal’s interest in valuebased care, designed to reward good outcomes, but remain concerned about the level of charity-care funding they receive to help offset the cost of uncompensated care. While these burdens have declined significantly since the ACA took effect, she said too many facilities are still struggling to provide for some of the state’s most vulnerable patients.
The real opportunity for collaboration comes in addressing the social determinants of health, underlying factors like poor housing, nutrition, poverty, and education, the CEOs agreed. Tackling SDOHs has been a priority for Bennett, who has a background in public health and created the Population Health Action Team, which brought together the heads of eight state departments, during her time as state health commissioner.
“Clearly this is one of those areas where we need to work together,” Sanders said. “There are enormous opportunities to identify folks that can have much better outcomes” and target them with more effective care, often involving preventative strategies or outpatient treatments instead of a stay in a hospital, he explained.
The leaders noted that, regardless of their own sectors’ performance, unrelated factors can have a profound impact on an individual’s health. While medication noncompliance — when patients fail to take drugs as prescribed — costs the pharmaceutical industry more than $300 billion annually, Paranicas said, the cause could be rooted in a lack of transportation to the pharmacy or an inability to read the label properly.
Bennett said a first step in addressing SDOHs is getting a better handle on the full scope of the problems and identifying where to target resources. “We need to marry clinical, public health, and other data,” she said, and individual patients must be part of the process.
The Garden State has been a pioneer in a number of healthcare innovations, she said, including developing Medicare Accountable Care Organizations and the “hot-spotting” technique created by Dr. Jeffrey Brenner, who founded the Camden Coalition of Healthcare Providers, she noted. “Let’s be first on this too,” Bennett said.