Suzanne Delbanco is Executive Director of Catalyst for Payment Reform, a non-profit corporation working to catalyze employers, public purchasers, and others to implement strategies that produce higher value health care. Delbanco will be the keynote speaker of the Quality Institute’s All Council Conference: Power of the Purchaser, on May 16.

For large employers that self-fund their health benefits, what are your top recommendations to drive affordability and quality?

First, choose a health plan partner carefully. Employers, historically, have chosen health plan partners that can get them the best discounts. That old way of thinking hasn’t led to better value. So it’s important to ask the health plan what they’re doing to change the way care is delivered. Ask about payment methods. Ask about the administration of new provider network designs, and benefit designs.

And look where there’s money spent on low-value care and try to reduce that. You can institute reference pricing, or use centers of excellence for some procedures. Look where there’s huge variation in cost — and where the quality also varies.

And the third area? Promote the use of alternative sites of care, where you can get the same level of care but at a lower price. An example is using telehealth instead of an emergency room.

In New Jersey, we have mostly small employers, often with fewer than 10 employees. How can these employers better engage their employees in their health and health care coverage options?

There’s still work to be done to convince people that sometimes less expensive care is as good, if not better, than more expensive care. Quality is really what you want people to be thinking about when they’re making healthcare choices. A small employer is unlikely to contract with say, Castlight, or another vendor, to provide that quality and price information about health care providers to their employees directly. So it’s really about selecting a health plan that has good tools and programs to educate employees.

And smaller companies can also look at some of the new products that are coming out from insurers, such as narrow networks, as options to offer on their own or alongside a traditional plan.

What’s your advice about controlling costs while also ensuring that employees have access to often life-changing medications?

As I talk to the employers and other purchasers in our membership, it is heartening that they really want to ensure access to these potentially life-changing medications for their populations. But they’re concerned about the economic implications. There’s more work to do to make sure these expensive medications are used appropriately. That means being specific about which patients would most benefit from particular drugs, and making sure that they’re gaining access to those drugs at a point in their illness when they’ll be most useful. And we need to think about the setting in which the drugs are administered. Getting an infusion at a hospital or doctor’s office, versus a freestanding center or at home, could mean a big difference in cost.

A decade from now, which of today’s innovations will have the most impact on improving the healthcare system?

I’ll say greater transparency. And I’m not just talking about access to information about provider quality or prices. Also transparency for the employer-purchaser about how well their health plans are performing. As an example, CPR just released a standard plan ACO report, a template report, that we want health plans to use in reporting the results of their ACOs to their employer customers. Our view is that health plans have been cherry-picking the results they are sharing.

And I also mean transparency for patients in additional ways.  My dad [Tom Delbanco] is leading a national program called Open Notes, where patients can read what their doctors write about them during their visit. This is empowering patients not only to be able to recall what they discussed with their doctor, but to be reminded of to-dos, and to have a chance to check accuracy. Ultimately these notes are going to become shared notes where the patients get to write in and report to their doctor between visits about how they’re handling a medication, or questions they have.

Your organization is piloting its payment reform Scorecard 2.0 in three states, one of which is New Jersey — where you are working with the Quality Institute. What insights do you hope to gain from this project?

We’re interested to see how payment reforms are taking root in three diverse states – New Jersey, Colorado and Virginia. On top of that we’re very excited to begin a process to see, at a macro level, the impact that payment reform is having on the healthcare system through the addition of some new metrics that we added to the scorecard methodology. It’s one thing to look at one payment reform program at a time and ask, for example, ‘Did the pay-for-performance program that one specific insurance company did with a particular health center lead to better outcomes for patients?’ It’s another thing to go up to the 20,000 foot view and ask, “Are sweeping changes to payment in the state leading to the kind of improvements in the health system that we’d expect to see?’ We think it’s important to look at the forest as well as the trees.

Published by Michael L. Diamond of the Asbury Park Press

Monmouth Medical Center received an A grade from a hospital safety watchdog group, marking the seventh consecutive report card that the Long Branch hospital has aced.

It was one of four hospitals at the Jersey Shore that received the top mark from The Leapfrog Group, a health care advocacy organization. Four others received B’s. And one was incomplete.

 “We now have more A’s and B’s than we did six months ago,” said Linda Schwimmer, president and chief executive officer of the New Jersey Health Care Quality Institute, who serves on the board of Leapfrog Group. “We are moving in an OK direction as opposed to the opposite.”

The Leapfrog Group is a coalition of big employers and other health care purchasers trying to call attention to hospital safety practices. It hopes to prompt hospitals to cut down on what it says are preventable errors that not only harm patients but also increase costs.

The Leapfrog Group estimates 200,000 people die each year because of  hospital errors.

It winds up with letter grades by looking at 27 safety measures, publishing them online twice a year. Some measures — like patient falls — are easily quantified. Other measures — like communication with doctors and nurses — come from patients’ perceptions.

One-third of New Jersey’s hospitals received A’s, ranking 17th nationwide. That was down from last fall, when 44 percent of New Jersey’s hospitals last fall received A’s, helping the state rank 11th.

University Hospital in Newark was given an F, the state’s first failing grade in the survey since St. Michael’s Medical Center in Newark received an F two years ago. (Saint Michael’s since has improved to a C.)

Also notable: Monmouth Medical Center, Southern Campus in Lakewood, formerly known as Kimball Medical Center, didn’t have a large enough patient base for the group to assign a grade, a spokeswoman from the hospital said.

“Now what we need to do is focus on getting hospitals that scored lower than (A’s and B’s) to really focus on safety and quality measures at their facilities to ensure every one in New Jersey, when they go to a hospital facility, knows they are walking in the door and people are focused on safety and quality,” Schwimmer said.

How did your hospital fare?

 1. Bayshore Medical Center, Holmdel

Spring 2018: A

Fall 2017: A

2. CentraState Medical Center, Freehold Township

Spring 2018: B

Fall 2017: B

3. Community Medical Center, Toms River

Spring 2018: B

Fall 2017: B

4. Jersey Shore University Medical Center, Neptune

Spring 2018: A

Fall 2017: B

5. Monmouth Medical Center, Long Branch

Spring 2018: A

Fall 2017: A

6. Monmouth Medical Center, Southern Campus, Lakewood

Spring 2018: N/A

Fall 2017: C

7. Ocean Medical Center, Brick

Spring 2018: B

Fall 2017: B

8. Riverview Medical Center, Red Bank

Spring 2018: A

Fall 2017: A

9. Southern Ocean Medical Center, Stafford

Spring 2018: B

Fall 2017: A

Published by Vince Calio on NJBIZ.

University Hospital in Newark was given an “F” grade for its safety conditions – the lowest possible grade – in The Leapfrog Group’s biannual hospital safety ratings. It is the first time in three years a New Jersey hospital has received an “F” grade.

In all, 22 hospitals earned “A” grades, down from 27 a year ago, with some significant downgrades. On the upside, four were upgraded from a “B” to an “A” and none received “D” grades for the first time in three years.

The Leapfrog ratings are based on on-site visits and outcomes data that are voluntary provided by the hospitals themselves. The company said its standards are updated annually to account for the latest science and designed to drive better patient outcomes.

The four hospitals receiving upgrades from “B” to “A” are Jersey Shore University Medical Center in Neptune, Capital Health Medical Center in Pennington, Overlook Medical Center in Summit and the University Medical Center of Princeton at Plainsboro.

CarePoint Health – Bayonne Medical Center in Jersey City and Virtua Memorial Hospital in Mount Holly were both downgraded to “C” grades after each received an “A” in the fall. Hackensack University Medical Center and Memorial Hospital of Salem County also were downgraded from “B” to “C” grades.

The entire list can be found here.

“Our efforts have always been grounded in quality and safety, and our concentration over the past two years to become a High Reliability Organization has enhanced our focus even further,” said Dr. Ken Sable, president of Jersey Shore University Medical Center, in an interview.

“Creating an environment of mindfulness, changing behaviors into habits, and empowering our team members to have a preoccupation with failure has fostered a relentless focus on quality,” Sable added. “Receiving an ‘A’ is a testament to the outstanding care our team delivers, and sets the bar for our continued emphasis on patient safety and transparency.”

Alan Lieber, Overlook Medical Center president, said in an email, “This accomplishment is due to efforts by our team that include intensive hand-hygiene compliance to reduce hospital-acquired infections, increased focus on patient safety indicators, and increased bedside scanning rates to confirm patients receive their appropriate medication. We look to build on this success and continue to provide the care and experience our patients expect and deserve.”

Meanwhile, Virtua Memorial pinpointed its lower score as “the result of an increased number of central line and catheter-related urinary tract infections in the beginning of 2017,” according to a prepared statement.

“Since that time, our clinical teams have worked diligently to correct the issues and have implemented changes,” the statement continued. “Over the last year, those changes have resulted in considerable improvement. We anticipate that Virtua Memorial’s October score will improve based on the efforts by our clinical team.”

Virtua Voorhees Hospital and Virtua Marlton Hospital did get “A” safety grades.

Leapfrog judged University Hospital in 30 different categories based on data taken from the Centers for Medicare and Medicaid Services, as well as on-site visits. The hospital, Leapfrog said, scored poorly compared to the national average in such categories such as doctor and nurse communication, staff responsiveness and discharge information.

In response to having received a failing grade, a spokesperson for University Hospital suggested Leapfrog used outdated data.

“Leapfrog uses a variety of factors when developing its grade, and the data can go back as far as 2014,” said the spokesperson in an email. “What we know by looking at our own data is that if Leapfrog used real-time or 2017 data alone, our grade would be in alignment with our national peers. But we are not satisfied with being average, either.

“We have an aggressive plan in place to get to an ‘A’ grade, and we remain focused on providing high quality care to all of our patients.”

Published by Anjalee Khemlani on ROI New Jersey.

New Jersey fell in national rankings of hospital safety scores, according to the biannual ranking by The Leapfrog Group.

The Washington, D.C.-based organization ranks the safety of hospitals every spring and fall, and the most recent report shows New Jersey is now No. 17 among 50 states, compared with ranking of No. 11 in Fall 2017.

The safety scores are increasingly important for the state, which has seen almost all of its hospitals consolidated into larger systems in the state or across the border in Pennsylvania.

“With more than 200,000 people dying due to errors in hospitals every year, communities must be vigilant in monitoring the safety records of their local facilities,” said Leah Binder, president and CEO of The Leapfrog Group. “The Leapfrog Hospital Safety Grade helps shed light on those hospitals in need of improvement, while also highlighting the safer facilities, to make it easy for patients to choose the best option for their care.”

Linda Schwimmer, CEO and president of the New Jersey Health Care Quality Institute and a member of the Leapfrog board, said overall, the state isn’t doing too badly, despite its drop in nationwide ranking.

“I’m not that worried about that. Overall, when you put the A’s and the B’s together, we have more than we had before,” she said. “The biggest concerns are the ones that are constantly in the bottom half.”

New Jersey had the distinction of being one of 10 states where there is at least one “F”-grade hospital this time. This Spring, that grade went to University Hospital, which dropped from a “D.”

It’s an especially bad time for the hospital to receive the grade, since it has recently engaged in a battle over trauma designation with Trinitas Regional Medical Center, which improved back to a “C” after slipping last fall to a “D.”

“The leadership of this hospital really needs to take a hard look at their patient safety outcomes and come up with a very focused plan on addressing the issues we are seeing. Its something that has been pretty consistent over the past couple years. Their grades have been low. They’ve, since the fall of 2016, they’ve been receiving a ‘D’ and this is their first ‘F,’” Schwimmer said.

Amanda Melillo, chief of staff at the NJHCQI, said University Hospital is going in the wrong direction.

“Where other hospitals use the survey to focus in on the quality and safety, and work on these grades, (University) is going in the wrong direction,” she said.

Other Trauma I hospitals in the state include RWJBarnabas Health’s location in New Brunswick, which improved to a “B,” and Cooper University Hospital in Camden, which stayed at a “C.”

But some do not believe the scores mean much, especially for trauma centers, which have certain guidelines for safety they follow.

In an article in USA Today in 2017, Trauma surgeon Ronny Stewart, who chairs the American College of Surgeons‘ trauma committee, said trauma centers meet rigorous national standards for continuous quality improvement that are verified by ACS.

Schwimmer knows that some people do not accept the scores, but believes it is the only transparent ranking.

“I know that people will point to other measures, but Leapfrog is the only transparent hospital safety measure,” she said. “(Centers for Medicare and Medicaid Services), for example, reports on the system as a whole, and now we have hospitals coming together in larger systems, if you’re just giving a grade or a star for the whole system, it would really mask differences between brick-and-mortar hospitals.

“And the actual location matters to you as the patient and how you are treated and the outcomes of your stay a that actual location.”

New Jersey is one of the few regions with consistently high hospital participation in The Leapfrog Group’s surveys and had the highest rate of survey participation in 2017 for regions with over 50 targeted hospitals, at 94 percent participation, according to a statement from Leapfrog on Tuesday.

The only eligible hospitals in New Jersey that do not voluntarily provide their hospital safety data to The Leapfrog Group are East Orange General Hospital, Hudson Regional Hospital in Secaucus (formerly Meadowlands Hospital Medical Center), Memorial Hospital of Salem County and St. Luke’s Warren Campus.

Here are how some of the hospitals fared:

Unlike the fall, none of the state’s health systems achieved a single ranking.

Hospitals that retained their “A” grades since the fall include:

  • Bayshore Medical Center
  • CarePoint Health – Bayonne
  • Clara Maass Medical Center
  • Hackensack University Medical Center
  • Holy Name Medical Center
  • Inspira Health Network – Vineland
  • Jefferson (formerly Kennedy) Health – Washington
  • Jefferson Health – Stratford
  • Monmouth Medical Center
  • Morristown Medical Center
  • Newton Medical Center
  • Riverview Medical Center
  • Robert Wood Johnson University Hospital at Hamilton
  • Saint Barnabas Medical Center
  • Shore Medical Center
  • The Valley Hospital
  • Virtua Health – Marlton
  • Virtua Health – Voorhees

The frequency of the reports gives hospitals an opportunity to quickly go up (or down) the rankings. Four, in fact, jumped into the “A” range:

From “B” to “A”:

  • Capital Health – Hopewell
  • Jersey Shore University Medical Center
  • Overlook Medical Center
  • University Medical Center of Princeton at Plainsboro (now Penn Medicine Princeton Medical Center)

From “C” to “B”:

  • Chilton Medical Center
  • Newark Beth Israel Medical Center
  • Raritan Bay Medical Center of Perth Amboy
  • Robert Wood Johnson University Hospital
  • St. Francis Medical Center
  • St. Mary’s General Hospital

From “D” to “C”:

  • Trinitas Regional Medical Center

A few did drop in grades:

From “A” to “B”:

  • Capital Health Regional Medical Center
  • CarePoint Health – Hoboken
  • Englewood Hospital and Medical Center
  • Inspira Health Network – Woodbury
  • Jefferson Health – Cherry Hill
  • Jersey City Medical Center
  • Robert Wood Johnson University Hospital- Somerset
  • Saint Peter’s University Hospital
  • Southern Ocean Medical Center

From “A” to “C”:

  • CarePoint Health – Jersey City
  • Vritua Health – Mount Holly

From “B” to “C”:

  • HackensackUMC at Pascack Valley
  • Memorial Hospital of Salem County
  • Raritan Bay Medical Center at Old Bridge

Princeton, New Jersey – April 24, 2018 – The Leapfrog Group, a Washington, D.C.-based organization aiming to improve health care quality and safety for consumers and purchasers, announced today the updated Leapfrog Hospital Safety Grades. General acute-care hospitals in the U.S. are assigned letter grades of A, B, C, D or F based on their performance in preventing medical errors, infections and other harms. These errors, killing or harming millions of people per year, are the third leading cause of death in the U.S.

New Jersey is one of the few regions with consistently high hospital participation in The Leapfrog Group’s surveys and had the highest rate of survey participation in 2017 for regions with over 50 targeted hospitals at 94.4% participation. The only eligible hospitals in New Jersey that do not voluntarily provide their hospital safety data to The Leapfrog Group are East Orange General Hospital, Hudson Regional Hospital in Secaucus (formerly Meadowlands Hospital Medical Center), Memorial Hospital of Salem County, and St. Luke’s Warren Campus. Of 65 New Jersey hospitals graded, 22 were awarded an ‘A,’ demonstrating excellence in patient safety. Those hospitals receiving an ‘A’ in New Jersey are:

Bayshore Medical Center

Capital Health Medical Center – Hopewell

CarePoint Health – Bayonne Medical Center

Clara Maass Medical Center

Hackensack University Medical Center (Hackensack)

Holy Name Medical Center

Inspira Medical Center Vineland

Jefferson Stratford Hospital

Jefferson Washington Township Hospital

Jersey Shore University Medical Center

Monmouth Medical Center

Morristown Medical Center

Newton Medical Center

Overlook Medical Center

Riverview Medical Center

Robert Wood Johnson University Hospital at Hamilton

Saint Barnabas Medical Center

Shore Medical Center

The Valley Hospital

University Medical Center of Princeton at Plainsboro

Virtua Marlton Hospital

Virtua Voorhees Hospital.

“With more than 200,000 people dying due to errors in hospitals every year, communities must be vigilant in monitoring the safety records of their local facilities,” said Leah Binder, president and CEO of The Leapfrog Group. “The Leapfrog Hospital Safety Grade helps shed light on those hospitals in need of improvement, while also highlighting the safer facilities, to make it easy for patients to choose the best option for their care.”

The New Jersey Health Care Quality Institute serves as the Regional Leader for The Leapfrog Group in New Jersey and Linda Schwimmer, the Quality Institute’s President & CEO, serves on the Leapfrog Board of Directors.

“Patient safety should be a priority for all residents of New Jersey. We are committed to ensuring our hospitals offer the best and safest care to their patients,” said Linda Schwimmer, President and CEO of the New Jersey Health Care Quality Institute. “We strive to work together with the hospitals and other stakeholders in our community to ensure excellent and safe care.”

Although New Jersey fell in The Leapfrog Group’s national ranking from #11 in Fall 2017 to #17 in Spring 2018 for percentage of ‘A’ hospitals within a region, 46 of the 65 hospitals graded in New Jersey received either an A or a B grade which is 5 percent higher than the last round. New Jersey has one straight A hospital since the grade’s inception in 2012: Saint Barnabas Medical Center.

12 hospitals went up in their grade, and 15 hospitals went down in their grade, “This level of fluctuation from a high grade to a lower grade, or from a lower grade to a higher grade underscores the importance of constant vigilance by hospital leadership and its professional staff to assure patients are receiving the safest possible care,” said Schwimmer. “It is not easy to keep safety processes functioning effectively every day which is particularly why we commend the hospitals that have maintained consistently high grades.”

New Jersey did have one hospital that received an F grade: University Hospital in Newark. This was one of 22 hospitals, nationally, that received an F.

Developed under the guidance of an Expert Panel, the Leapfrog Hospital Safety Grade uses 27 measures of publicly available hospital safety data to assign grades to approximately 2,500 U.S. hospitals twice per year. It is peer-reviewed, fully transparent and free to the public.

To see the complete Leapfrog Hospital Safety Grade and access consumer-friendly tips for patients, visit www.hospitalsafetygrade.org, and follow The Leapfrog Hospital Safety Grade on Twitter and Facebook. Journalists interested in scheduling interviews should email SternLeapfrogTeam@SternStrategy.com.

About The New Jersey Health Care Quality Institute

The New Jersey Health Care Quality Institute is the only independent, nonpartisan, multi-stakeholder advocate for health care quality in New Jersey. The Quality Institute’s mission is to undertake projects and promote system changes that ensure that quality, safety, accountability and cost-containment are closely linked to the delivery of health care services in New Jersey. Learn more about us at www.njhcqi.org and follow us on Twitter, Facebook and LinkedIn.

About The Leapfrog Group

Founded in 2000 by large employers and other purchasers, The Leapfrog Group is a national nonprofit organization driving a movement for giant leaps forward in the quality and safety of American health care. The flagship Leapfrog Hospital Survey collects and transparently reports hospital performance, empowering purchasers to find the highest-value care and giving consumers the lifesaving information they need to make informed decisions. The Leapfrog Hospital Safety Grade, Leapfrog’s other main initiative, assigns letter grades to hospitals based on their record of patient safety, helping consumers protect themselves and their families from errors, injuries, accidents, and infections.

CONTACT:

Carol Ann Campbell

New Jersey Health Care Quality Institute

973-567-1901

cacampbell@njhcqi.org

www.njhcqi.org

Published by Steven Porter in Healthleaders Media

Maryland and New Jersey passed laws designed to help stabilize their health insurance markets.

As the federal government continues to denounce the Affordable Care Act (ACA) and neutralize some of its requirements, certain states are responding with countermeasures of their own.

New Jersey lawmakers sent a bill Thursday to Gov. Phil Murphy that would reinstate a state-level individual mandate to require most insurers to have health insurance or pay a penalty, as the Asbury Park Press reported. A separate state bill would establish a reinsurance plan funded partly with federal dollars.

“It’s a two-pronged attack to get at premium costs,” New Jersey Health Care Quality Institute President and CEO Linda Schwimmer told the Press.

Other states are considering similar policies to stabilize their insurance markets.

Maryland Gov. Larry Hogan, a Republican, recently signed the Maryland Health Care Access Act of 2018, which reinstates a fee insurers used to pay through the ACA, as The Frederick News-Post reported. The fee is expected to funnel about $300 million into the Maryland Health Benefit Exchange Fund.

“Increasing rates have been a problem now for close to a decade and are a direct result of massive changes to our health care laws made in Washington. And the problems have only increased due to the lack of action in Washington,” Hogan said, as the News-Post reported. “The stakes here were tremendous, but we faced this crisis together, and we addressed it head-on.”

The bill also requires that a study be conducted to recommend further stabilizing measures Maryland may implement over the coming year.

Andy Slavitt, who served as acting administrator of the Centers for Medicare and Medicaid Services (CMS) under former President Barack Obama, said New Jersey and Maryland are leading the way to shore up the ACA despite efforts to undermine Obama’s signature healthcare law.

“What states do today, the country will do beginning 2021,” Slavitt wrote Thursday in a tweet.

But others are less convinced that state efforts will be able to solve the ACA riddle, as Sam Baker wrote last month for Axios. Baker cited several reasons, including the fact that state-level individual mandates aren’t significantly more popular than the federal-level mandate was.

Steven Porter is editor at HealthLeaders Media.

 

Published by Michael L. Diamond in the  Asbury Park Press

 Murphycare could look a lot like Obamacare.

Lawmakers Thursday sent to Gov. Phil Murphy a bill that will require nearly all New Jerseyans to have health insurance or pay a penalty, in a bid to stabilize premiums for consumers in the Obamacare marketplace.

They approved another bill that would set up a reinsurance plan that would be paid partly for by the federal government and cover some of the most expensive health care claims.

“It’s a two-pronged attack to get at premium costs,” said Linda Schwimmer, president and chief executive officer of the New Jersey Health Care Quality Institute, a research and advocacy group.

The mandate bill passed 23-13 in the Senate and 50-23 in the Assembly. The reinsurance bill passed 22-14 in the Senate and 46-22 in the Assembly. Health Commissioner Shereef Elnahal in the video above discusses the state’s plans to protect Obamacare.

The bills would most directly affect consumers who don’t get health insurance through Medicare or their employer. About 275,000 people in New Jersey were covered in the individual market, according to federal data released this month.

They are steps by the Democrat-controlled Legislature to protect the Affordable Care Act in the face of opposition from the Trump administration and Congress.

The Trump administration eliminated the contentious provision for 2019 as part of the tax reform law, and it turned its attention to giving states more flexibility to offer less expensive — and less comprehensive — plans.

New Jersey long has required insurance companies to provide “essential” benefits that mirrored Obamcare: hospitalization, maternity care and preventive care such as colorectal screenings, to name a few.

The bill headed to Murphy would penalize consumers who purchase a plan that doesn’t include comprehensive benefits.

Most New Jersey consumers buying health insurance through the Obamacare marketplace have an income that is low enough to qualify for subsidies. If they don’t, the price is steep; a four-person family pays about $23,000 a year, according to New Jersey Policy Perspective, a left-leaning research group.

A recent Rutgers University poll found just 40 percent of New Jerseyans thought the state should continue the mandate, but health care experts have said it would help stabilize premiums.

Without it, they said, young, healthy people would drop out of the market, leaving older and less healthy people stuck with the bill, making health care even less affordable.

 The result: Premiums in New Jersey were expected to increase up to 32 percent next year — and 90 percent over the next three years — because of uncertainty in the insurance market, according to a report released by California’s insurance marketplace.

“Health insurance works when everyone is in,” state Sen. Joseph Vitale, D-Middlesex, and one of the bill’s sponsors, said last month.

The reinsurance bill would create a program to pay for high-cost patients. It would be funded by both the federal government and insurance companies. And the money would be kept in a newly created fund at the Treasury Department.

Minnesota created a reinsurance program for 2018. Its Blue Cross Blue Shield plan said it raised premiums just 2.8 percent this year.

Michael L. Diamond; @mdiamondapp; 732-643-4038; mdiamond@gannettnj.com