How is Medicaid approaching care for complex populations, particularly children?
I’m really proud of the number of important investments that we’re making to modernize Medicaid in the governor’s budget. That includes investing $17 million in new state and federal funds that are going to help us expand autism spectrum disorder benefits for children. There are thousands of young people in our state with autism spectrum disorder, and, until now, in New Jersey Medicaid we were able to cover less than 200 of them in a small pilot. Also, New Jersey Family Care offers programs for children with serious emotional concerns, for individuals with intellectual and developmental disabilities who have co-occurring mental conditions, and other benefits for children with complex needs. Our programs will continue to emphasize the role and importance of home and community-based services.
How will Medicaid support the move away from fee-for-service to outcome-based payments?
I think there’s a lot we can learn from other states, from Medicare, and from the private market, as we look to maximize quality outcomes. Frankly, some of that’s about learning not only what works, but what doesn’t. As we look to innovate, we also need to recognize that there are significant cohorts of providers that are just transitioning to a Medicaid fee-for-service environment, whether that’s in our developmental disabilities program or in our mental health and substance use disorder program, and we need to be sure that we’re working with those providers and the individuals they serve to make these transitions successful as well.
How is Medicaid working to reduce the total cost of care while maintaining its commitment to the health of our most needy residents?
New Jersey Medicaid serves about 1.7 million residents, which is about 20% of our state’s population, and so we have tremendous purchasing power. We’re exploring ways to better leverage that purchasing power to advance our Medicaid program and more effectively drive health care quality. We need to look toward value-based purchasing models and payment models, such as episodes of care, which have the potential to improve quality and outcomes.
How does your work as senior health policy advisor in the Obama White House and a member of the domestic policy council health team inform your goals here in New Jersey?
I’m grateful to have worked on implementing the Affordable Care Act and expanding health insurance coverage for millions of Americans. I was really honored that the governor asked me to bring my experience home to New Jersey to focus on strengthening and protecting access to affordable health care and the health care safety net.
The governor recently announced that he intends to spend $100 million to address the opiate crisis, most of which will be directed to expanding treatment access and maintaining existing programs. What impact do you think this will have?
This investment will allow us to focus on the full continuum of opioid use disorder treatment. We’re currently implementing a Medicaid waiver that will expand our complement of Medicaid opioid use disorder services, including inpatient treatment and expanding medication assisted treatment. But what the new investment will really do is the necessary work of helping to strengthen our footprint on outpatient treatment. We need to support community providers and community-based treatment as part of the solution to this epidemic, and that’s what the budget focuses on. We’re also proposing as part of that $100 million to build up our data analytics capacity around opioid use disorder. At the end of the day, our knowledge and response capacity is only as good as the timeliness of our data. In addition, the governor’s budget really says that prevention, recovery, and treatment are not just about health services, but also about addressing the social risk factors that influence substance use disorders.
So it’s a sunny afternoon, and you have a chunk of time off from work. Where will we find you?
My answer is the beach, always the beach. I’m from Cape May, so we always say, the beach!