Coordinated-care effort likely to win backing from state’s biggest insurers [NJBIZ (NJ)]
By Fitzgerald, Beth | |
Proquest LLC |
Experts said Medicaid ACOs now taking shape in
Accountable-care organizations represent a new approach to health care delivery that seeks to coordinate medical care, engage patients in their own wellness, and improve health and control costs.
"Medicaid ACOs will provide a model for intensive communitybased care coordination and case management, which will improve members' health care experience and outcomes while reducing
The state issued regulations for the ACOs earlier this month, and once they're final, local consortiums of health care providers are likely to be certified by the state
Cantor is helping ACOs implement the three-year pilot's central "gain-sharing" feature: If the ACO saves the government money, some of those gains flow back to the ACO, to be reinvested in better services. Cantor said a recent study by the center identified "millions in potential savings."
Dr.
The ACO's gain-sharing component "creates a business model for doing the right thing," he said. With a population of about 79,000,
Brenner is optimistic savings could exceed 5 percent, though. "The system is so broken that if we fix how health care is delivered, there will be a huge payoff for
New Jerseyans join
Bonaparte said he'll want to partner with ACOs whose primary-care doctors are transforming their practices toward the patient-centered medical home model. In this model, patients with chronic medical conditions, like diabetes, get intensive monitoring, education and follow up to avoid complications that land them in the hospital.
An ACO built with patient-centered medical home practices "would give me some comfort," he said, "because at a minimum, I will know that a transformation has occurred at the primary physician level."
He said a Medicaid ACO should provide patients with easy access to clinicians by phone, at night and on weekends, to avoid overusing hospitals.
"We have a high ER rate for
The state
E-mail to: [email protected]
On Twitter: @bethfitzgerald8
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