Hackensack Meridian Health, in Partnership with the VNA, NJHCQI and NJ Medicaid Receives $15.8 Million Award from CMS to Implement New Payment Model to Improve Care for Pediatric Patients with Complex Medical Conditions

January 3, 2020

Hackensack Meridian Health is honored to announce that it has received an award from the Centers for Medicare and Medicaid Services (CMS) in the amount of $15.8 million to be distributed over seven years to establish the New Jersey Integrated Care for Kids (InCK) Model that will test an Alternative Payment Model (APM) for the Medicaid program supporting multi-sectoral integrated case management and pediatric practice capacity-building in Monmouth and Ocean Counties. Hackensack Meridian Health is the administrative lead organization and is partnering with co-lead organizations, the VNA of Central Jersey (VNA), the New Jersey Medicaid Agency, and the New Jersey Health Care Quality Institute (Quality Institute) on this initiative. Hackensack Meridian Health will partner with the VNA and a broad-based Partnership Council (PC) to monitor and execute the model, while the state’s Medicaid office, Hackensack Meridian Health and the Quality Institute will work collaboratively to design and implement the APM.

The goal of this population-based approach and the associated APM is to identify children and adolescents who are covered under New Jersey Medicaid and who have higher than average health issues as indicated by a combination of factors, including medical, behavioral and social risks. Once identified, this model aims to improve their outcomes, including reducing Emergency Department use, inpatient admissions and out-of-home placements for escalated behavioral needs and substance use disorders through integrated care coordination and case management.

“We are so excited to have been selected as a recipient of this cooperative agreement on behalf of the state of New Jersey,” says Robert C. Garrett, CEO of Hackensack Meridian Health. “This is a novel concept that, once proven, can be replicated throughout the state, and we are truly energized to begin implementation with these tremendous partners, who were integral to being awarded this cooperative agreement.”

Only eight awards were issued by CMS across the country and the one awarded to Hackensack Meridian Health, the VNA and the Quality Institute, was the only one given in New Jersey. The impact of early identification and immediate support of at-risk New Jersey children and families is two-fold, leading to improvements in health and service accessibility and health outcomes for the highest risk children who will receive integrated care coordination and case management by Hackensack Meridian Health and the VNA, and lower acuity children will benefit from improved capacity of primary care offices to screen for, and address, risks.

“The location for New Jersey’s InCK Model is rich in resources but has very deep silos of care due to a ‘home rule’ civic structure, where the organization of school districts, public health departments and other health and human services activities are dictated by individual municipalities,” says Thomas Thees, executive director, VNA of Central Jersey. “We are thrilled to be able to work with Hackensack Meridian Health and the Quality Institute to break down some of these silos in order to better integrate resources to improve the care of New Jersey’s most vulnerable children and are grateful to CMS for selecting our organizations for this initiative.”

“This model aims to improve the care of children with complex needs through early identification and integrated care management, while reducing costs that typically have been associated with disjointed and high-acuity care, creating a model that is better for everyone,” said Linda Schwimmer, CEO and president of the Quality Institute. “We are eager to work directly with the NJ Medicaid team and we’re thankful to CMS for entrusting us with this innovative concept.”

ABOUT THE VISITING NURSE ASSOCIATION OF CENTRAL JERSEY AND FAMILY HEALTH INSTITUTE
Visiting Nurse Association of Central Jersey Inc. (VNACJ) is an independent nonprofit organization dedicated to helping individuals and families achieve their best level of well-being by delivering vital community services to those in need. The organization’s vision is to lead the transformation of the health of the community to achieve the highest level of quality, access, value and overall wellness. Since its inception in 1912, the agency’s philosophy has been that health care services should be available and accessible to all, regardless of their circumstances.  As a safety-net provider, VNACJ has been on the frontlines of community health providing community-based programs and services for children and adults of all ages.  In 2012, VNACJ launched the Children and Family Health Institute (CFHI), now headquartered in the Freehold Medical Arts Building at 597 Park Avenue in Freehold Borough, to improve access to community-based care for at-risk children and their families, offering a “no wrong front door” approach. Through more than 20 grant- and philanthropically-funded programs, and strategic affiliations with four VNACJ Community Health Centers, a staff of over 300 work to provide a foundation to support healthy and functional families that can advocate for their own health care needs and for resources needed to improve the health and wellbeing of their communities. For more information, please visit www.vnacj.org

ABOUT THE NEW JERSEY HEALTH CARE QUALITY INSTITUTE
At the Quality Institute, we believe that collaboration is essential to improving our health care system. That’s why we bring providers, payers, patients and decision makers together to advance health care safety, quality and affordability. We’re the only independent, nonpartisan advocate working in New Jersey to promote accountability and transparency. We have more than 100 unique member organizations— all committed to improving health care for everyone in New Jersey. The Medicaid Policy Center (MPC), a program of the Quality Institute, is dedicated to advancing the quality and cost effectiveness — and long-term sustainability — of the New Jersey Medicaid program to improve the health and wellness of New Jersey residents.