Tuesday, August 23, 2011

Coughlin, Greenwald & Riley Bill to Improve Quality of Health Care for Medicaid Recipients Now Law

(Trenton) - Legislation sponsored by Assembly Democrats Craig J. Coughlin, Louis D. Greenwald and Celeste Riley creating a three-year pilot program to improve health care outcomes, quality and access for Medicaid recipients at reduced costs has been signed into law.

The law (S-2443/A-3636) creates the Medicaid Accountable Care Organization (ACO) Demonstration Project.  Under the program, nonprofit groups can apply to provide health care to Medicaid fee-for-service recipients residing in an area with more than 5,000 Medicaid recipients.

Providers that can deliver improved care, expand access to primary and behavioral health care services, and reduce unnecessary and inefficient costs associated with care rendered to Medicaid recipients would be entitled to gain sharing or cost savings payments from Medicaid.

"This program will provide improved health care at reduced costs for New Jersey's most vulnerable patients, many of whom have limited access to coordinated and primary care services, and tend to delay care, underutilized preventive care, and seek care in hospital emergency departments for preventable problems," said Coughlin (D-Middlesex).

"The ACO model is recognized as a mechanism that can be used to improve health care quality and health outcomes, while lowering the costs of medical care by providing incentives to coordinate care among providers throughout a region," said Greenwald (D-Camden).  "This is welcomed news for Medicaid patients and taxpayers."

"People often assume better health care means higher costs, but this program has shown the opposite," said Riley (D-Salem/Cumberland/Gloucester).  "I'm hopeful that after the trial period, it will serve as a model for achievement of improved health care at lower costs that can be replicated in other settings to the benefit of patients and taxpayers throughout New Jersey."

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