I recently read with great interest and respect a newspaper commentary by Laura Landy, president and CEO of the Fannie E. Rippel Foundation. Landy, whose organization is a Morristown-based foundation committed to healthcare, raised several sobering truths about the need to rethink our healthcare delivery system. I couldn’t agree more.
Our healthcare system is broken. More than 1 million New Jerseyans have no health insurance. Patients, both those with insurance and those without, continue to flood hospital emergency rooms rather than use more appropriate and affordable primary care services. Prices are rising, hospitals are closing. And while New Jersey has had impressive gains in health outcomes and patient safety, there’s still room for improvement.
The overuse of healthcare services in our state is a key contributing factor, and it’s something that we’ve been focused on here at NJHA since the Dartmouth Atlas of Healthcare first published data on this problem in 2006. The greatest expense in healthcare, especially in New Jersey, comes in the last six months of life. We’ve been working closely with the Medical Society of New Jersey to address this issue through education and legislation. The New Jersey Legislature recently passed a bill called POLST that would empower patients to express their end-of-life care choices.
The reality is, more healthcare does not always equal better healthcare. Too often, extensive and invasive medical treatment yields no benefit to the patient at the end of life. We will continue our efforts with physicians, hospital leaders and healthcare consumers to re-enforce the idea that patient preferences, comfort and dignity must always be the driving force in end-of-life care.
NJHA also is taking the lead in new models of reimbursement to help sustain our healthcare system. Our “gainsharing pilot project” has the backing of the federal government to test a new incentive program where doctors and hospitals are encouraged to work together to find ways to improve care while reducing costs. Seems like a simple concept, but our insurance system pays hospitals and physicians in different ways, creating a barrier for the two sides to come together in this common cause. So far, our results have been very promising in reducing healthcare costs while maintaining the quality that patients demand.
New Jersey hospitals also have received national attention, including a recent article by Dr. Atul Gawande in The New Yorker, for their innovative efforts to create community-based “medical homes” for uninsured patients. Successful efforts have risen in Camden and Atlantic City and we’re working to extend that model to other parts of our state.
As the Fannie E. Rippel Foundation rightfully notes, our ultimate goal is better health, better care and lower costs. We’ve signed our name to that pledge through the nationwide Partnership for Patients, and so have many hospitals and healthcare providers across the state. Much work remains, but we’ve made some important steps. Innovative thinking and willing partners do exist in this quest for a better healthcare system.
