When Vermont introduced the nation’s initial patient-first program for its public workers a decade ago, the plan helped slash inpatient hospital stays by 21 percent.
Trips to the state’s emergency rooms fell by 31 percent, officials said, and health-care costs dropped by 12 percent.
Now New Jersey is about to get a dose of the same medicine, under a program called R-Health Primary Care.
Under projections outlined by state Senate President Steve Sweeney, with the backing of labor unions, the model has the dual goals of improving patient care and reducing costs to taxpayers.
Since November, four primary-care practices have opened their doors – in Burlington, Camden and Mercer counties, as well as in Pennsylvania, across the river from Trenton – to treat public workers for free.
N.J.’s pilot program to cut health care costs
When it’s fully up and running, the program is expected to cover at least 60,000 of the state’s 700,000 teachers, police, firefighters, and state and local government employees.
Sweeney’s vision is based on a simple philosophy: Allowing doctors to spend more time with their patients and better understand their concerns keeps patients healthier, while cutting reducing the need for further (read: expensive) treatment down the road.
In a meeting with the Times of Trenton editorial board two years ago, when the program was still in the planning stages, the lawmaker noted that 84 percent of every healthcare dollar goes into controlling chronic diseases like diabetes and heart disease – conditions that are relatively manageable with proper maintenance.
He predicted the initiative could save taxpayers up to $150 million a year.
The most recent site opened in Ewing last month, offering preventive care, chronic disease management, wellness coaching and sick care, NJSpotlight reports.
Instead of rewarding doctors for providing more treatment for cramming more patients into the work day – the traditional fee-for-service billing – R-Health pays doctors a set amount regardless of how many people they see.
While primary-care physicians typically are responsible for up to 3,000 patients, the pilot program limits them to 1,000.
The program is available to current and retired employees and family members covered by the State Health Care Benefits Plan or the State Education Health Benefits Plan, if they are not in an HMO plan or eligible for Medicare.
There’s no fee for signing up, and no change to existing insurance plans. Participants are not barred from visiting other doctors in their plan’s network.
It’s way too soon to tell if R-Health is “really transformational,” as its CEO Mason Reiner calls it. But if the initiative helps reduce the $3.7 billion budgeted this year to cover the cost of caring for its employees and retirees, it’s well worth exploring.
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