Providing insurance to low-income populations, as Medicaid does, improves their overall health and helps maintain financial stability. A new study by the National Bureau of Economic Research, says that Medicaid recipients, on average, were more likely to seek preventative services, be healthier and overall feel better than people without insurance.

Of course, there are ways to improve care especially for people with complex conditions. A new initiative in New Jersey provides a great example: policymakers, advocates, and consumers are hoping new legislation will lead the way to deliver quality care and save costs. The Medicaid ACO Demonstration Project nearly unanimously passed in the NJ Legislature in June and awaits Governor Chris Christie’s signature. This legislation would authorize the Department of Human Services to create a three-year Medicaid ACO (Accountable Care Organization) Demonstration Project where community-based, non-profit coalitions can apply for recognition by the State of New Jersey as a Medicaid ACO. The Medicaid ACO Demonstration Project intends to:

  1. Increase access to primary, behavioral and dental care, in specific regions where Medicaid recipients reside
  2. Improve health outcomes and quality by measuring patient experience
  3. Reduce unnecessary and inefficient care without interfering with patients’ access to their health care providers or the providers’ access to existing Medicaid reimbursement systems.
One of the poorest cities in New Jersey, Camden, led the way to create a system to improve the delivery of care to the sickest and poorest population, while lowering costs. The innovative care delivery system in Camden is led by Dr. Jeffrey Brenner and the Camden Coalition of Healthcare Providers. The critical issue in Camden and cities across New Jersey is to reduce readmissions to hospitals and better address the needs of the Medicaid population.

Atul Gwande highlighted the work in Camden in his “The Hotspotters” article in the New Yorker, and groundwork has been set for two similar citywide healthcare coalitions in Trenton and Newark, as well. And now New Jersey has legislation that will hopefully spread this new model of care across the Garden State.

Another great example of innovative care is the Boston-based Commonwealth Care Alliance (CCA). CCA has created a comprehensive system of care that not only improves their members’ health, but also has been proven to lower costs by keeping people out of the hospital and out of nursing homes. The organization has created a system of care and support for the neediest population on Medicare, Medicaid or so-called “dual eligibles” who receive support from both programs.

At a time when states are facing severe budget deficits, states need to explore options within Medicaid to help sustain state budgets while creating an efficient and coordinated system of care for patients. Community Catalyst has highlighted alternatives for states:

We know that Medicaid matters. If we can curb cost by addressing the needs of the high utilizers of Medicaid by coordinating better care, we can create a system that works for everyone. Massachusetts has shown us through the work of CCA, and now New Jersey is paving the way for their Medicaid population.

— Leena Sharma, Field Coordinator