Sweeney Pilot Aims to Save Money, Improve Public-Employee Healthcare

Senate President Stephen M. Sweeney has unveiled a proposal for a pilot project that -- if successful -- could go a long way toward saving money on health benefits for state workers while keeping them healthy.

The pilot would start with as many as 60,000 of the 800,000 public workers in the state’s two major health insurance plans. Rather than a conventional fee-for-service model, the project is based on “patient-centered healthcare,” in which doctors are paid based on seeing a limited number of patients, with bonuses awarded for keeping those patients healthy.

Public-employee insurance programs currently cover about 9 percent of New Jersey residents.

Patient-centered healthcare is similar to the healthcare delivery model increasingly used by self-insured health plans as well as government programs like Medicare and Medicaid. Accountable-care organizations are also based on variations of the concept that doctors’ pay should be tied to patient outcomes.

Sweeney said he’s hopeful that the proposal would reduce monthly insurance premiums, which saw a sharp increase in worker contributions over the past four years. He said it was “a concept that will actually improve care and reduce costs. I know that’s hard to believe, but it is doable.”

Under the proposal, primary-care doctors would see a maximum of 1,000 patients, rather than the 1,500 that is typical in New Jersey. This is intended to allow the doctors to spend more time with each patient, including giving them age-appropriate tests and screenings intended to catch serious health issue before they cause crises.

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