Health care is moving away from a volume-focused fee-for-service model toward patient-centered primary care homes that reward providers for healthy outcomes.
If you have little idea what that means, join the club.
A new public education project is getting off the ground to try to both understand consumers’ concerns and teach them how to get the most out of the healthcare system. Even some of Better Choices, Better Care NJ’s steering committee members say they joined the effort in part so they can learn.
“As a consumer, I don’t understand our health care system. I don’t understand the cost. I don’t understand the care component, which is all over the board,” said Tom Bracken, president and chief executive officer of the New Jersey Chamber of Commerce, who said it’s a top concern of businesses.
Steering committee member John Harmon, president and chief executive officer of the African American Chamber of Commerce of New Jersey, said the goal is to study and explain what people and businesses get for their health care bucks.
“We want better value for the moneys that we are spending. Folks don’t mind paying if they understand what they’re paying for and clearly understand what they’re going to get at the end of the day,” Harmon said.
One of the new organization’s labor representatives, Lizette Delgado-Polanco, executive director of the Service Employees International Union New Jersey State Council, voiced similar frustration.
“I interact with our members all the time, and one of the biggest issues is that they do not understand how the system works,” Delgado-Polanco said.
“There is a problem. Everyone agrees,” Harmon said. “No one really knows what’s in the sausage, so we’re trying to do an intrinsic look at what’s in the sausage and engage consumers from around the state.”
“The system is broken because nobody knows how it works. We don’t know where it’s going to go. Nobody knows where it’s going to go,” Bracken said.
‘Better Choices, Better Care NJ’ holds a news conference at the Statehouse. (Michael Symons/Townsquare Media NJ)
Other members of the new organization do seem to have an idea where things are going – patient-centered care, in which doctors are compensated for keeping patients healthy, not for each service or test they provide.
People need to better understand the shift, and how they can benefit, said Christine Stearns, a director with Gibbons P.C. and the new organization’s executive director and general counsel. That is one of the goals of the education campaign, she said.
“That’s part of the problem, how policy folks speak in a language that individual consumers – sort of, if you’re not someone who sits at those policy tables, it’s not intuitive,” Stearns said.
The new organization is being funded by a grant from Horizon Blue Cross Blue Shield of New Jersey, which is emphasizing new patient-centered insurance plans it calls Omnia. The amount of the financial support is still being negotiated, Stearns said.
The organization doesn’t include any hospitals, though it does have a primary care doctor, Dr. Joyce Nkwonta, who is on staff at John F. Kennedy Medical Center in Edison.
Its steering committee includes Horizon’s chief strategy officer, Dr. Minal Patel, who said the organization can focus on ways to get the healthcare system more focused on patients.
“We as a state can do much better. We have the institutions, the facilities, the physicians that can really makes us a shining beacon for our state,” Patel said. “New York and Philly, sometimes we live in their shadows. From a clinical, medical point of view, doesn’t have to be the case anymore.”
New Jersey Citizen Action, a liberal grassroots advocacy group, said healthcare solutions should be consumer-driven, not reliant on insurers.
“While insurers are a valuable partner at the health reform table, they cannot lead the charge to combat high health care costs,” said Maura Collinsgru, the group’s healthcare program director.
Better Choices, Better Care NJ plans policy meetings and public forums and invites comments about what concerns residents about health care.
It’s an approach different from what has been tried anywhere in the country, said steering committee member Laurel Pickering, president and chief executive officer of the Northeast Business Group on Health.
And given the escalating cost of health insurance, and the increased emphasis being put on high-deductible plans, the public education campaign is urgently needed, she said.
“It’s the reason why something like this is so critical, because people are using their own money to buy healthcare services in a way that they have not been in the past, so the value for those services is much more critical than what they’re ultimately going to get,” Pickering said.