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Three health agencies from throughout the state selected
Trenton – The Christie Administration today announced the selection of three health care agencies to launch New Jersey’s first state-subsidized Accountable Care Organizations (ACO), groups made up of physicians, hospitals and other health professionals to coordinate patient care in cost-effective ways.New Jersey has had active ACOs since 2011, but this is the first group that will be contracted by the state to serve Medicaid members.

“New Jersey began reforming its Medicaid program five years ago, each budget year pursuing new initiatives to improve access and quality of care for participants,” said Elizabeth Connolly, Acting Commissioner with the Department of Human Services (DHS), which administers Medicaid. “We’re very eager to launch this innovative delivery system reform effort for the benefit of the members and overall efficiency of the program.”

The selected agencies include:
• Camden Coalition of Healthcare Providers
• Healthy Greater Newark ACO
• Trenton Health Team
The Medicaid ACO demonstration project provides the New Jersey Medicaid program an opportunity to explore innovative system re-design including;: testing the ACO as an option to managed care; evaluating how care management and care coordination can be delivered to high risk, high cost utilizers; integrating essential medical services with important social services; and, testing payment reform models including pay for performance metrics and incentives.
“The level of interest and partnership in this effort is staggering. We see tremendous potential in the ability of these communities to coordinate care in a way that makes sense for their Medicaid residents and provider community,” said Medicaid Director Valerie Harr. “We hope this is the tip of the iceberg and encourage other ACOs to continue to develop their model for future opportunities.”

New Jersey’s Medicaid ACO applicants were required to be nonprofit organizations serving a minimum of 5,000 Medicaid beneficiaries within a designated region. In addition, the ACOs are required to contract with 100% of the hospitals, 75% of the primary care providers and at least four mental health providers within the intended service region.  Each selected agency  is required to submit a gainsharing plan by June 30, 2016 for review and approval by DHS.  Once approved, gainsharing payments will be distributed pursuant to the plan.

New Jersey Medicaid will enter into a Business Associates Agreement with the ACOs in order to provide claims data for beneficiaries residing in each designated region, which will allow the state to effectively support the efforts of the ACO in determining health outcomes, quality and cost of care.

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