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Whelan Applauds New Federal Rules For Accountable Care Organizations

Says Federal Rules Advanced Last Week Are In-Line with State Efforts to Control Healthcare Costs, Improve Patient Outcomes

TRENTON – State Senator Jim Whelan today applauded new federal rules advanced last week regarding accountable care organizations (ACOs), saying that the new rules create a coordinated approach to health care which will ultimately save Medicare dollars and improve patient outcomes.

The federal rules mirror an existing State proposal, sponsored by Senator Joseph F. Vitale, D-Middlesex, and Senator Whelan to incorporate ACOs in the care model for recipients of the State Medicaid program in New Jersey.

“I applaud the Obama Administration’s adoption of the ACO model of health care to bring down costs and improve results for seniors on Medicare,” said Senator Whelan, D-Atlantic. “We’ve taken that same approach to create comprehensive, cost-effective care under the State Medicaid program. On the federal and State levels, ACOs have the potential to yield significant cost savings while making sure that people receive access to the medical care they need to stay healthy.”

The new rules, announced Thursday by the Obama Administration, establish guidelines for how ACOs will operate under the federal Medicare model for seniors and people living with permanent disabilities who qualify for the program. ACOs are networks of health care professionals and facilities – hospitals, doctors, rehabilitation facilities, specialists, and others associated with the provision of health care – dedicated to providing complete, comprehensive and cost-effective health care. The result is substantial savings to the entire program, and better patient outcomes for individuals receiving care.

Under the ACO model of health care, federal Health and Human Services Secretary Kathleen Sebelius projected cost savings of as much as $960 million over a three-year period for the Medicare program.

“At a time when more and more people are turning to government safety-net programs for access to vital health care services, the ACO model of care extends our existing programs and stretches our investment in health care further than ever,” said Senator Whelan. “We have an obligation to make sure that accessible, affordable care is available to individuals who would otherwise do without. By spending our health care dollars more wisely, we can make sure that we get the maximum benefit for minimum cost to the taxpayers.”

The new federal rules are in-line with Senator Whelan’s bill, S-2443, which would create the “Medicaid Accountable Care Organization Demonstration Project” to ensure that low-income Medicaid recipients in New Jersey have access to high-quality, cost-effective medical care. The bill would establish a demonstration project within the State Department of Human Services to increase access to primary care, behavioral health care, and dental care by Medicaid recipients in a particular region. The bill would also improve the quality of health care by establishing objective metrics and relying on patient experience, and would reduce unnecessary and inefficient care without interfering with a patients’ access to the health care providers and services they need to stay healthy.

“ACOs have the potential to fundamentally change how health care services are delivered in New Jersey and throughout the country,” said Senator Whelan. “By taking a collaborative approach to health care, ACOs can eliminate duplicative tests and treatments, and focus on the root cause of illness or injury. At the end of the day, this proposal will allow us to target our health care dollars to services with a proven track record of success, and will allow us to take a patient-centric approach to health care moving forward.”

Senator Whelan’s bill, S-2443, was recently approved by the State Senate and is pending consideration in the General Assembly.

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