Happy Labor Day! Labor Day is dedicated to the social and economic achievements of American workers and specifically honors the legacy and ongoing work of the nation’s labor unions. It’s an annual national tribute to the contributions workers have made to the strength, prosperity and well-being of our country. And it’s the perfect opportunity to salute New Jersey’s healthcare workers who are on the front lines taking care of New Jersey 24/7/365.

New Jersey hospitals employ about 140,000 individuals. Thousands more across our state are employed by nursing homes, home health agencies, rehabilitation facilities and other healthcare sites. All told, the healthcare sector is the second-largest source of jobs in the Garden State. Their contributions to New Jersey’s economy are essential to our state’s economic well-being. Those 140,000 hospital jobs bring with them $8 billion in annual salaries and $400 million in state income taxes.

But the added value of healthcare workers’ care, compassion and commitment is immeasurable. Those dedicated individuals serve more than 18 million hospital patients each year, including 3.7 million people who come to hospital emergency rooms in dire need of help. They will be there for you this holiday weekend, as they are every day of the year.

We at NJHA mourn the passing of Senator Frank Lautenberg.  He has been a devoted public servant to our state and is our longest serving senator in New Jersey history. He is also the last World War II veteran to serve in the U.S. Senate.  Sen. Lautenberg was always a supporter of New Jersey healthcare providers and the patients they serve and was always willing to hear our concerns over his many years of service as an elected official. He championed many consumer health issues, including efforts to forbid smoking in public places such as airplanes and even the U.S. Senate complex. He also was an ardent supporter and protector of prescription drug benefits for New Jersey seniors and the State Children's Health Insurance Program, which led to the NJ FamilyCare program. We will miss his stellar leadership, and we extend our condolences to his family, friends and his staff.

The federal Medicare program generated headlines this week when it released a big spreadsheet listing hospital charges for a number of different procedures. The numbers were compelling by the sheer fact that they varied so widely, across the nation and even within states. Seems like everyone from news anchors to Princeton economist Uwe Reinhardt debated whether this information on charges carries much relevancy. Virtually everyone acknowledged that what hospitals list as charges and what they actually get paid from Medicare, Medicaid and commercial insurance companies are two very different sets of numbers. But today, I want to cut through the clutter and just share three very important things that New Jersey healthcare consumers need to know about hospital charges and medical bills.

1. The overwhelming majority of you will never, ever see a bill that includes hospital charges. Only about 4.5 percent of N.J. hospital patients could potentially be billed at charges. These are the individuals who earn too much to qualify for a subsidized insurance program like Medicaid or NJ FamilyCare and who opt not to purchase insurance on their own.
2. A 2009 state law caps hospital charges for most uninsured patients. Any individual earning up to $117,750 annually for a family of four would have any hospital charges capped at 115 percent of what Medicare would pay for the same service. And since Medicare only pays N.J. hospitals about 90 percent of their costs, the “charge” to these patients would be just slightly above what it costs hospitals to provide their care.
3. And to the small group of individuals who may be billed at charges – or even for those insured patients who face major medical bills that their plans do not cover: Contact your hospital and ask about discounts and payment plans. Almost all New Jersey hospitals have a set of compassionate billing guidelines to work with patients who are struggling with medical bills.

New Jersey hospitals are working hard to reinvent healthcare to ensure continued quality and access through more efficient, effective healthcare services. That is essential as hospitals face significant federal Medicare cuts at the same time they are preparing to care for our aging population and the added demands of a greater number of insured individuals. “Value” is the bottom line – care that is high in quality but delivered efficiently and in the right setting.

New Jersey hospitals have been working to improve health, provide better care and reduce costs long before the enactment of the Affordable Care Act, but the ACA has pushed us to do more. To that end, N.J. hospitals are:

• Improving coordination of services across the continuum of care. Whether they are forming their own “accountable care organizations” or reaching out in greater collaboration with local post-acute partners, hospitals are forging new relationships, embracing technology like electronic health records and regional sharing of information and using new tools like the state’s Universal Transfer Form to ensure better communication and continuity of care.
• Testing new payment models that promote collaboration. 31 New Jersey hospitals have joined NJHA in a federal pilot project called “gainsharing,” which allows hospitals and physicians to work in collaboration to find ways to streamline patient care and reduce in-hospital costs.
• Investing resources, staff and energy to improving healthcare quality. NJHA’s Institute for Quality and Patient Safety is leading New Jersey hospitals in the federal quality improvement initiative called Partnership for Patients. In the first year of this effort, they have produced tremendous results that not only make care safer for patients, but also reduce healthcare costs in the long run. Those achievements include a 65 percent decline in pressure ulcers, a 45.8 percent decline in ventilator-associated pneumonia and additional improvements in reducing healthcare-associated infections and hospital readmissions.

April is Donate Life Month, a nationwide event to raise awareness about the importance of organ donation. There are so many people in need of organs or tissue. Nationwide, there are more than 115,000 people awaiting a life-saving transplant. In New Jersey, there are close to 5,000 people. Sadly, each day in the United States, an average of 18 people die waiting for a transplant. 

You, and all New Jerseyans, can help. It’s as simple as designating yourself as an organ donor on New Jersey’s Donate Life Registry maintained by the N.J. Motor Vehicle Commission.

Across the United States, more than 44 percent of U.S. drivers are registered organ donors, but New Jersey ranks a disappointing 44^th out of 50 states. Only 32 percent of our drivers registered to donate.  All major religions support organ and tissue donation, and one donor can save up to eight lives.

Donation is the ultimate gift – a life-saving one.  If you are not registered to donate, please consider doing so. It’s easy, and it’s an awesome feeling to be a hero.