State Health Benefits Quality and Value Task Force’s Final Report Identifies Savings

Identifies Opportunities for Hundreds of Millions of Dollars in Savings

Gov. Phil Murphy’s State Health Benefits Quality and Value Task Force released its final report on recommended longer-term strategies to improve health outcomes for members and better manage the costs of employee and retiree health benefits. Together, the State Health Benefit Plan (SHBP) and School Employees’ Health Benefits Program (SEHBP) cover approximately 820,000 people at a cost to the state and local participating employers of about $5.79 billion in 2019. The State of New Jersey spends about 8.4% of its budget on these programs, or about $3.2 billion in 2019.

“Now more than ever, this work is critical to the well-being of our public members, the SHBP and SEHBP, as well as the financial well-being of our State as we look toward economic recovery post pandemic,” said Governor Murphy. “I want to commend all of our members of the Task Force for their dedication and hard work to identify real solutions that will help increase accessibility and availability – particularly in primary care and behavioral health – that will move us toward a stronger, fairer, and more resilient New Jersey.”

The Task Force recommends nine strategies for long-term improvement in quality and value, organized into three thematic areas: Primary care and care coordination; Behavioral health; and Specialty care, and has the potential to improve access to care, outcomes, and member experience, while also mitigating growth in health care expenditures over the next five years and potentially beyond. Below is an overview of the themes and summary recommendations:

  • Primary care and care coordination: Solutions may include a combination of value-based payment for advanced primary care; direct contracting for primary care; and helping members navigate their benefits and the health care delivery system.
  • Behavioral health: Solutions may include integrating behavioral health more closely with primary care; direct contracting for mental health and substance use disorder treatment; and strengthening the behavioral health workforce.
  • Specialty care: Solutions may include reference-based pricing; centers of excellence; and episode-based payment

The strategies recommended in the final report could—by the report’s estimates—collectively generate savings of up to $380 to $420 million over five years, and up to $160 to $180 million in recurring annual savings, if fully implemented. These savings are made possible by directing members to hospitals, physicians, and other health care providers that deliver high-quality care at a lower overall cost and by investing in expansion of high value primary care and improved behavioral health access, which is arguably more important than ever.

For a copy of the final report, please click here.

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