Two numbers struck me after reading Catalyst for Payment Reform’s New Jersey Scorecard: 80 and 20. In our state’s commercial market, the share of total dollars paid to specialists (outpatient and inpatient) is 80 percent compared with just 20 percent to primary care providers. The national figures are only slightly better: 75 and 25 percent.

What’s wrong with this picture?

Nationally, the rise in health care spending is not sustainable. The health share of gross domestic product (GDP) is projected to rise from 17.9 percent in 2016 to 19.7 percent in 2026 — assuming annual increases of 5.5 percent annually. To control spending and achieve better health, purchasers and providers are working to improve the way we pay for health care.

As we move toward more coordinated and value-based care models, we need to right size our investment in preventive health and primary care. We need to shift funding to primary care and support technology that enables providers to electronically share clinical records, as well as communicate with patients and other providers caring for them. Primary care must be team-based, with care coordinators, nurses, mental health providers, social workers, and therapists. Comprehensive primary care is the essential underpinning for all other value-based care.

The Quality Institute has partnered with Catalyst for Payment Reform (CPR) to explore how well New Jersey is moving toward payment models tied to better care and reduced costs. The New Jersey CPR Scorecard is the first look ever in New Jersey at the pace of change by provider type. It is a good first step to track our progress.

If you don’t know about CPR, the non-profit, national organization advocates for health care purchasers to get better value for their health care dollars. CPR leaders joined us on Tuesday at our Quality Breakfast where we released the Scorecard — and we also brought in health care leaders from around New Jersey to discuss its findings.

I was impressed with our panelists, including those who explained their challenging work to bring care coordination to the very center of their practice models. Carefully coordinating and following patients with chronic illness, for instance, can reduce emergency visits and hospitalizations, reducing costs and improving care.

Our providers on the panel said they invested heavily to strengthen care coordination of the patients within their primary care practices, but patients risked getting lost when they went outside their system to, say, nursing homes or specialists who did not always communicate back to the primary care practice.  All acknowledged that the move to value-based payments is challenging.

But everybody in our audience and on our panel — both payers and providers — genuinely appeared to support the need for this work. They believe this is the right direction. Now we need greater investment in our primary care infrastructure, including health information technology, especially since New Jersey has a high percentage of small, independent primary care practices.

Our partnership with CPR and Tuesday’s Quality Breakfast was intended to provide us with a baseline as we move toward payment reform. That’s the right first step. We need to know where we are today before we can move forward.

From left to right: Linda Schwimmer, CEO, the Quality Institute; Kate Gillespie, MBA RN NE-BC, AVP, Orthopedic and Spine Service Line, Virtua Health; Behnaz Baker, CIO and Director of Integration & Population Health, Riverside Medical Group; Dini Ajmani, Assistant Treasurer, Department of the Treasury; Jamie Reedy, MD, MPH- Summit Medical Group, PA and Summit Health Management, LLC; Christine A. Stearns, Director, Gibbons P.C.; Alex Binder, MBA, Vice President, Advanced Care Institute, VNA Health Group Andrea Caballero, MPA, Program Director at CPR; Alejandra Vargas-Johnson, CPR staff.