New Jersey Senate Bill S2821

New Jersey 2022-2023 Regular Session

• Introduced: 6/9/22
• Refer: 6/9/22

Caption

Requires Medicaid and NJ FamilyCare managed care organizations to offer patient-centered medical home model or other alternative payment model to primary care providers.

Impact

The legislation is expected to transform how primary care services are delivered within New Jersey's Medicaid framework. By requiring managed care organizations to implement these models, the state aims to enhance patient care continuity and overall healthcare quality. It introduces a structured approach for these organizations to follow in providing services and aims at standardizing the compensation models that primary care providers will utilize. The bill will likely impact existing policies around provider reimbursements and healthcare outcomes evaluation.

Summary

Senate Bill 2821, introduced in New Jersey, mandates that managed care organizations providing services under Medicaid and NJ FamilyCare must offer a patient-centered medical home model or alternative payment models to primary care providers. The patient-centered medical home model is defined as a team-based healthcare delivery system that aims to provide comprehensive, continuous care focused on patient needs and improving health outcomes. The bill emphasizes a shift towards rewarding healthcare providers for high-quality, cost-efficient care.

Contention

One notable contention surrounding SB 2821 is the discretion it gives to the Division of Medical Assistance and Health Services to waive the requirement for offering a patient-centered medical home model. Managed care organizations could opt for alternate payment models that satisfy similar objectives. This flexibility may be viewed favorably by providers who wish to innovate outside standard practices; however, critics might argue it could lead to variability in care quality. Additionally, the introduction of standardized quality metrics mandated by the bill may also raise concerns about the administrative burden on smaller practices.