The HART Program produces reports in two workstreams:

1. Measuring health care cost growth in New Jersey and comparing it to the benchmark.
2. Analyzing the drivers of cost growth in the State.

Benchmark Reports

• Health Care Cost Growth Benchmark Report: Pre-Benchmark Year (2018-2019) (PDF) (September 2024)

Cost Driver Reports

• Health Care Spending Trends for New Jersey Residents with Commercial Insurance, 2016–2021 (PDF) (September 2024)
• The Health Care Landscape in New Jersey: Select Indicators of Quality, Access, and Affordability (PDF) (September 2024)

Implementation Resources

• State Benchmark Program Implementation Manual (PDF)
  • The Implementation Manual explains the technical and operational steps the state will take to implement the health care cost growth benchmark. The Implementation Manual contains the methodology used to set the health care cost growth target, and the methodologies for calculating performance against the target.
    
    
• Carrier Benchmark Data Submission Guide (PDF)
  • The Carrier Benchmark Submission Guide contains the technical specifications for data reporting and collection, timelines, data due dates and where to submit the data.

• Carrier Benchmark Data Submission Template (Excel)
  • The Carrier Benchmark Data Submission Template is the reporting template to be utilized by data submitters.

• Carrier Benchmark Data Submission Frequently Asked Questions Log (PDF)

Medical Debt

A recent survey   has indicated that 41% of adults in the United States have some debt caused by medical or dental bills. That same survey found that patients with medical debt postpone receiving needed care due to medical debt or are denied care by providers due to unpaid bills, and report having to cut spending on food and other essentials. The impact of medical debt is also most keenly felt in communities of color. In some counties in New Jersey the ratio of the percent of the population with medical debt in collections in communities of color vs. those in white communities exceeds 4-to-1   .

The Louisa Carman Medical Debt Relief Act

The Governor’s Office of Health Care Affordability and Transparency worked to support the passage of the Louisa Carman Medical Debt Relief Act.

The Act prohibits medical creditors and debt collectors from reporting a patient’s medical debt to any consumer reporting agency for health care services delivered after the bill’s effective date, and prohibits medical creditors or debt collectors from:

• Making a consumer report containing a patient’s paid medical debt or a medical debt worth less than $500, regardless of the date the medical debt was incurred;
• Charging an interest rate on a medical debt of more than three percent per year;
• Garnishing the wages of a patient with an annual income of less than 600 percent of the federal poverty level to collect medical debt owed by that patient; or
• Engaging in any collection actions against a patient until 120 days after the first bill for a medical debt has been sent or against a patient who accepts and complies with the terms of a reasonable payment plan.

The Act further renders void any debt reported to a consumer reporting agency in violation of the bill and provides that any medical creditor or medical debt collector that violates a provision of the bill may be subject to a civil penalty and ordered by the Attorney General to restore money or property acquired by means in violation of the bill.

Undue Medical Debt

OHCAT and the Governor’s Office established a partnership with Undue Medical Debt   to use American Rescue Plan funds to purchase and abolish medical debts for New Jerseyans at or below 400% of the Federal Poverty Line. The program, focusing on vulnerable New Jerseyans in the hardest hit communities in the state, has abolished over $1.2 Billion in debt for over 770,000 people.

Here is a YouTube Video of Governor Phil Murphy discussing the medical debt abolishment program.

Pharmaceutical Affordability Efforts

The Governor’s Office of Health Care Affordability and Transparency worked to support the passage of legislation aimed at addressing the rising costs of prescription drugs in New Jersey.

• S-1614 – Caps out-of-pocket costs for many residents by extending Medicare’s new $35/month insulin out of pocket cap to state-regulated markets and NJ public employee plans, as well as capping out of pocket costs for EpiPens and asthma inhalers at $25 and $50 respectively for a month’s supply.
• S-1615 – Creates a new data and transparency system within the Division of Consumer Affairs to collect, analyze, and report on the entire process of drug pricing across the supply chain in an effort to gain greater insight into drugs with high price increases and launch prices. The bill also establishes a Drug Affordability Council to formulate legislative and regulatory policy recommendations that help advance the goal of prescription drug affordability and accessibility. For more information on these efforts, see DCA’s Drug Affordability Unit.
• A-536/2841 – Establishes greater oversight of Pharmacy Benefit Managers (PBMs), the third-party companies who manage many prescription-drug plans, to prevent certain practices that drive up costs. This bill requires rebates to be used to lower premiums and out-of-pocket costs for consumers and prevents the practice of spread pricing (when a PBM pockets the difference between what it charges a health plan and reimburses a pharmacy). It also requires PBMs to apply for a license from the NJ Department of Banking & Insurance to strengthen regulatory oversight; information on DOBI’s oversight is available here.