Gov. Chris Christie said today he was “proud” of his decision to expand Medicaid through the Affordable Care Act, but plans to introduce better oversight to the $12 billion program so it can serve the 1.4 million people who rely on it for health care, housing and other services.
In his budget address today, Christie took aim at what the medical professionals call “super-utilizers:” the people with chronic health conditions that frequently end up in emergency rooms and get admitted to the hospital. He said he has enlisted the nine schools that make up Rutgers Biomedical and Health Sciences, as well as University Hospital in Newark, and Rutgers Camden, to find a more cost-effective way to reduce their reliance on costly hospital care.
“Last year, 5 percent of Medicaid recipients accounted for 50 percent of the costs,” Christie said. “More than 16,000 Medicaid recipients visited emergency rooms six or more times last year.”
He added, “I am proud to have made the decision to expand Medicaid and provide greater access to healthcare for New Jerseyans in need. But greater access necessitates larger reforms as well.”
The key is managing patient care more closely, Christie said, and the state is working with insurance carriers that provide Medicaid coverage to develop an “accountable care organization” to track these patients more carefully.
Rutgers Center for State Health Policy and the Robert Wood Johnson Foundation released a study Monday based on hospital admission data from 2007 to 2010, that found 55 percent of patients with 15 or more admissions visited more than one hospital. One in five had used three or more hospitals.
The state’s Medicaid program would get $200 million more in Christie’s $34.4 billion budget. He agreed to expand New Jersey’s Medicaid program under President Obama’s Affordable Care Act last year. In his next budget, the state will get about $100 million from the federal government and $100 million from the state.
Larry Downs, chief executive of the Medical Society of New Jersey, a lobbying group for doctors, said they “have a unique frontline perspective of the barriers and problems inherent in the current Medicaid program.”
“It remains a stubborn fact that access to physician services, particularly specialty care, is a challenge in the New Jersey Medicaid program,” Downs said. “Our citizens deserve access to a wide range of both primary care and specialist physicians when they need them.”
The budget also dedicates $125 million in state Medicaid funds to providing home-based support services to prevent senior citizens and adults with disabilities from needing institutional care.
Christie’s budget commits a total of $985.1 million toward hospital aid – the same amount as the current budget. But he deducted $25 million from the charity care pool, reducing it to $650 million, and moved $25 million to University Hospital “to continue to support its role as a health care cornerstone of the Newark Community, including maintaining its status as a Level 1 Trauma Center.”