Stakeholders convene to review NJ Medicaid delivery system reforms

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A lively discussion moderated by Dave Knowlton, president and CEO of the NJ Health Care Quality Institute (NJHCQI), brought consumer advocates together with state policy directors and insurance executives, as well as academic researchers and service providers, to share feedback and lessons learned from year one of the state’s most recent delivery system reforms.

Co-sponsored by the Good Care Collaborative, a coalition for sensible statewide Medicaid reform convened by the Camden Coalition, and the QI Collaborative, a learning and resource network for ACOs organized by NJHCQI, the event brought diverse stakeholders together for a frank and constructive discussion of the recent implementation of managed long-term care services and supports (MLTSS). The Rutgers Center for State Health Policy is in the process of analyzing first year data and conducting an in-depth evaluation of this phase of New Jersey’s shift of Medicaid benefits administration from the state to managed care organizations (MCOs).

The event opened with Knowlton’s statement that we are “building on a very strong foundation that is radicalizing how we are delivering care in Medicaid and elsewhere.” He praised the state’s pivot to person-centered care, noting that in 2015, 35 percent of NJ Medicaid’s long-term care recipients were in home and community-based care, the highest percentage ever in the state. Lowell Arye, deputy commissioner of the New Jersey Department of Human Services, noted that the historic shift to managed care is “still in the toddler stage” and therefore at a crucial stage for evaluating what has worked and what still needs improvement.

Evelyn Liebman, associate state director of advocacy for AARP NJ, reminded the group that the goal of MLTSS reforms was “strong care coordination in place that not only educates consumers but does a good job of assessing needs along a continuum of care and puts together the services that are needed and ultimately improves the quality of life.”

Referencing the AARP’s Long Term Care Scorecard, which measures state’s system performance from the viewpoint of service users and their families, Liebman noted that in Minnesota, the state rated number one in overall quality, 70 percent of long-term care recipients are in home and community-based care, indicating that New Jersey can continue to make improvements in this area.

The panel agreed that while stakeholder engagement was strong, more frequent and direct communication between beneficiaries and advocates and the state and providers would benefit all parties. Carol Grant, chief of the Office of Managed Health Care in NJ’s department of Human Services, welcomed the help of the consumer advocates to “improve our listening.”

“This is a very vulnerable and fragile population,” noted Jennifer Langer Jacobs, vice-president of Long Term Services and Supports for Amerigroup NJ, Inc. “And a very complex issue – not just medical but social. Because of that, this kind of constant dialogue is necessary.”

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