In your new role as President of AmeriHealth New Jersey, how do you see your vision and goals?
Our mission is to enhance the wellbeing of the people we serve in New Jersey. We want to keep earning our reputation as a reliable, innovative company that personally engages our members and helps transform the health care delivery system in our state. We’re exclusively focused on New Jersey and see ourselves as the market disruptor — always innovating and adapting to the changes in the market.
How is AmeriHealth New Jersey innovating to make health care more affordable and accessible?
We compete and innovate through our products, networks and strong relationships with our provider partners. Our AmeriHealth Advantage Suite of health plans is a prime example.
These tiered health plans enable people to have an advantage in out-of-pocket expenses when they use one of our Tier 1 providers. It’s one of our most affordable options, and there’s a lot of interest in that product. In addition, we are able to exchange data in real time with providers, which helps them more effectively manage patients.
How else can we make health care more affordable?
At the end of the day, we all have to address the underlying cost of health care: the cost of medical services and also the cost of prescription drugs. Consumers are spending much more on prescription drugs, particularly the high-cost specialty drugs that are name brand. This contributes to the overall increase in premiums over time. Additional challenges come as we are extremely heavily mandated as a state, which also contributes to costs. There are also challenges with special open enrollment periods. These things have to be addressed as we talk about improving affordability.
You are one of two insurers in the ACA marketplace. What are your thoughts on the plans to repeal or repair the ACA?
We will continue to watch the bill closely as it moves to the Senate. We support solutions that make health care more accessible for consumers and measures that provide stability and security in the marketplace. Our top priority is to ensure a smooth transition for our members to whatever comes next.
As you look at changes in the ACA, what needs to go and what needs to stay in the marketplace?
Under current rules, too many people are allowed to purchase coverage only when they get sick and then drop it after they receive care. No other type of insurance works this way. This is driving up premiums for everyone and is not fair to those who stay covered continuously and pay their premiums year-round.
As a bonus question, tell something about you. It’s a day off and the sun is shining. Where can we find you?
If it’s a sunny day I am definitely heading toward the beach.
I am a Jersey Shore guy. Seabright and Monmouth Beach area. And for a good boardwalk, it’s Belmar or Spring Lake.