A Healthcare Coalition

Posted on by Renée Steinhagen

By Renee Steinhagen

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NJ Appleseed’s Role in the New Jersey and Greater Newark Coalitions

Since our inception, NJ Appleseed has focused its efforts on health care issues, providing a legal voice to communities and organizations seeking to establish health care as a social right by preserving hospitals as charitable community assets, improving access to quality, affordable health care services, and diminishing racial disparities in the health status of Newark residents. Our work in this area can be characterized as three distinct projects: The Community Health Assets Protection Project (representing the community in administrative and court procedures to ensure that hospital boards satisfy their fiduciary duties to the public when seeking to merge or sell their charitable health assets to a for-profit entity or another nonprofit with a different mission); a Consumer Advocacy Project and a Transforming Healthcare Delivery Project.

Under the rubric of our Consumer Advocacy Project, NJ Appleseed has participated on the leadership team of the NJ Healthcare Coalition since its founding in 2006. As the only legal organization participating in the Coalition (Legal Services of NJ informally participates but is not a member), NJ Appleseed services the Coalition, its individual members and the public generally with respect to legal policy issues, including drafting and analyzing legislation, preparing regulatory comments, and preparing white papers and consumer manuals with respect to legal rights, such as the right to appeal insurance denials of benefits. We are now considering whether to convert the New Jersey Sentinel website (which was product of a joint project between NJ Appleseed and Seton Hall Law School, funded by RWJ Foundation to evaluate essential benefits) into a comprehensive consumer health care website that provides information directly to New Jersey consumers on how to navigate the insurance, health care (providers), and public health systems in the State, and perhaps the website could deal with occupational health and safety as well as environmental health issues.

Since the closure of St. James and Columbus hospitals in Newark, NJ Appleseed’s Executive Director has been a board member of the Greater Newark Healthcare Coalition (consisting of a wide array of providers, including hospitals, physicians, federally qualified health centers, nurses, etc.), which was established as the Hospital CEO Working Group as a result of those closures. The Coalition is a planning organization that oversees various projects that seek to transform the healthcare system so it is more equitable, socially and racially just, and effective in improving the health status of Newark residents. NJ Appleseed is the Chair of the Legal and Advocacy Subcommittee, which is the one Board committee that draws mainly from persons who are not represented on the board. As one of three non providers on the board –- representatives from NJIT and Seton Hall Law School are the other two –- NJ Appleseed is trying to bring the consumer perspective to the Board’s decision making, and to encourage community participation in the organization’s activities.

We are seeking resources to support our activities in these two coalitions.

Advisors

NJ LEGISLATURE CALLS ON CONGRESS TO PRESERVE THE AFFORDABLE CARE ACT

Posted on by Mary Pat Gallagher

Despite the human and fiscal harm that would result from repeal, Republicans have pronounced it a priority and on January 4, the Senate took an initial step toward that goal, approving a budget resolution that would clear the way for such legislation. The House is expected to follow suit next week.

In its last frenzied voting session before the end-of-year break, the New Jersey Legislature passed a resolution that calls on Congress not to repeal the Affordable Care Act, or ACA, also commonly referred to as Obamacare. The complete text of Assembly Concurrent Resolution 222 can be found here.

Continue reading NJ LEGISLATURE CALLS ON CONGRESS TO PRESERVE THE AFFORDABLE CARE ACT

LEGISLATION TARGETS $1 BILLION SURPRISE MEDICAL BILL PROBLEM

Posted on by Mary Pat Gallagher

Surprise medical bills for out-of-network health care cost New Jersey residents nearly $1 billion per year, according to a report released last June by New Jersey Policy Perspective.

An estimated 168,000 people in the state receive out-of-network (OON) bills totaling $420 million per year but the actual cost is much higher because OON charges drive up the cost of the health insurance premiums paid by roughly 5 million New Jerseyans, for an estimated total cost of $956 million.

Continue reading LEGISLATION TARGETS $1 BILLION SURPRISE MEDICAL BILL PROBLEM

How will sale of Saint Michael’s Hospital transform healthcare in Newark?

Posted on by Myles Zhang

Written by Andrew Kitchenman

The answer lies with the Christie administration and which of several competing options it decides to pursue

Governor Chris Christie’s administration has put off for nearly three years deciding what it should do about the future of healthcare in Newark. But the scheduled sale of the bankrupt Saint Michael’s Medical Center, one of five Newark hospitals, should force a decision.

The outcome of the sale will likely help shape the quality of healthcare that Newark residents receive, according to industry attorneys and analysts. It could also affect the financial stability of all of the city’s hospitals.

State involvement in hospital bankruptcies normally is limited to issues related to operating licenses. But not in this case, for three reasons:

First, the New Jersey Health Care Facilities Financing Authority, which is chaired by Acting Commissioner of Health Cathleen Bennett, issued tax-exempt bonds for Saint Michael’s that currently total roughly $230 million.

Second, the state also owns another troubled Newark facility — University Hospital, which is facing millions of dollars in annual operating losses for the foreseeable future.

Third, if the state allows the sale of Saint Michael’s it should get a short-term financial shot in the arm. But if were to decide to take over the facility, it could realize a greater payback over a longer period.

Continue reading How will sale of Saint Michael’s Hospital transform healthcare in Newark?

Surprise Medical Bills: What they are and how to stop them

Posted on by Myles Zhang

New Jersey’s leading consumer health coalition held a press conference today announcing the release of a new report, Surprise Medical Bills: what they are and how to stop them . The report examines the consequences and costs of these bills on New Jersey health care consumers and details the remedies necessary to fix the problem. and contains more than a dozen testimonials from consumers who have fallen victim to these out-of-network bills.

Continue reading Surprise Medical Bills: What they are and how to stop them

As investors buy struggling hospitals, big change comes to New Jersey health care

Posted on by Myles Zhang

Re-post from NorthJersey.com | Written by Lindy Washburn

Bayonne Medical Center wasn’t just bragging about efficiency when it posted a big digital clock on a highway billboard a few years ago to show the real-time waits in its emergency room. It wanted patients to come to its ER. Lots of patients.

It didn’t matter if the hospital was in the patient’s insurance network. On the contrary, to the businessmen who had recently purchased the medical center, those “out-of-network” patients held the key to reversing Bayonne’s fortunes.

These owners, who bought the hospital in bankruptcy, had found an unintended — and very profitable — consequence to a state regulation that was designed to protect patients with urgent medical needs. While the regulation required insurance companies to pay for emergency treatment at hospitals where their coverage wasn’t normally accepted, it did nothing to control the size of the bills the hospitals could submit to those insurers.

Read rest of article here and how this topic relates to NJ Appleseed’s work.

New Jersey’s Vanishing Non-Profit Hospitals

Posted on by Renée Steinhagen

Starting this year, New Jersey nonprofit hospitals are set to be sold to out-of-state, for-profit entities at an alarming rate. New Jersey is already home to for-profit hospitals in which profitability seems to rest largely on complicated sale-leasebacks of their land and buildings, patient admissions through the emergency room that allow for excessive charges for “out-of-network” care, and other predatory practices.

These for-profit models appear to be in direct contrast to the goals of health reform, which call for reducing unnecessary treatment, increasing patient satisfaction and ensuring that all Americans have access to primary and preventive care in community settings, while reducing expensive emergency room use.

Continue reading New Jersey’s Vanishing Non-Profit Hospitals