Requires SHBP and SEHBP to implement referenced based pricing program and bundled payment program.
Impact
The expected impact of A2063 on state laws is significant as it introduces new methodologies for pricing healthcare services to public employees and retirees. By establishing a referenced based pricing program, the bill aims to standardize costs for elective medical procedures by benchmarking them against external pricing mechanisms. This may lead to reduced healthcare expenditures for the state while maintaining quality. The implementation of bundled payment programs could streamline payments to providers, potentially enhancing efficiency in care delivery and patient satisfaction.
Summary
Assembly Bill A2063 mandates the implementation of a referenced based pricing program and a bundled payment program for the State Health Benefits Program (SHBP) and the School Employees Health Benefits Program (SEHBP). This legislation targets the pricing of certain elective medical procedures, allowing the State Health Benefits Commission and School Employees’ Health Benefits Commission to establish contracts with healthcare marketplace vendors to control costs and promote the delivery of high-quality care. The bill amends existing N.J. statutes regarding health benefits to adapt to these new pricing frameworks and operational processes.
Contention
There may be points of contention regarding A2063 focused on the extent of control over pricing and the implications for healthcare providers. Critics may argue that referenced based pricing limits the ability of healthcare providers to negotiate rates and that bundled payments might inadvertently undermine comprehensive care for certain patients. Moreover, stakeholders may be concerned about how these changes will affect non-emergency care availability and the quality of services provided to public employees.