To help achieve interdepartmental collaboration, the transition team report calls for the state to create an Office of Healthcare Transformation. The entity could tackle complex efforts to improve Medicaid and the state Health Benefits Plan (which covers state workers) and establish and enforce statewide efficiency goals and other healthcare program targets.
The report also underscores the importance of addressing the state’s opioid epidemic, which killed more than 2,000 residents last year. It calls for more education on the dangers of prescription drugs, expanding needle-exchange programs, investing in proven treatment programs, and organizing bulk purchases of overdose reversal agents like Narcan.
In addition, the report’s authors stress the need to better integrate mental health and addiction care — many patients are impacted by multiple diagnoses — and also coordinate these treatments with physical medical services: “New Jersey’s regulatory systems unnecessarily frustrate the implementation of integrated clinical care, leading to shortage of appropriate care for those in crisis, and for those whom crisis could be avoided.”
Within six months, a backlog of applications from providers seeking to integrate care programs should begin to be cleared, establishing a working group to discuss reimbursement rates and initiate efforts to create an up-to-date directory of treatment services.
Much of the report addresses strategies to expand enrollment in the state’s Medicaid program, which now insures some 1.8 million people, including nearly 500,000 who joined as a result of the ACA expansion. In his first week in office, Murphy signed an executive order calling on state agencies to study how they can promote and publicize access to these subsidized programs.
It also recommends the use of best-practice methods, especially to improve maternal care — an area in which New Jersey has fallen behind other states. The racial disparity in maternal death rates is among the worst in the nation. Low-cost changes, like expanding prenatal care and codifying clinical practices, can go a long way toward improving outcomes.
Other efficiencies can come from better documenting and coordinating end-of-life care — Medicaid also funds 65 percent of nursing home care, which isn’t covered by Medicare, and advanced planning can significantly reduce costs at this stage. The transition team urged Murphy to build on the state’s existing efforts to institute a comprehensive program to track residents’ wishes for final treatments.
The report also calls for the state to review its Medicaid managed-care contracts. The state now spends $2 billion annually, after rebates, on drugs for Medicaid patients and government workers.