First published by Lindy Washburn on www.courierpostonline.com

Medicaid, the taxpayer-funded insurance program that covers one in five New Jersey residents, should be modernized and streamlined to deliver better care more efficiently, according to a non-profit group that released 24 recommendations for improvement Monday at a State House news conference.

With future federal funding for the program uncertain, it’s urgent that the state take steps now to protect the health care of 1.8 million New Jersey residents, said leaders of The Nicholson Foundation, which funded the year-long study by the New Jersey Health Care Quality Institute.

The changes the group recommended wouldn’t make up for a possible repeal of the federally funded expansion of Medicaid that added more than 550,000 new enrollees in New Jersey under the Affordable Care Act. But they provide a road map for the next decade to help the program serve patients better, while squeezing out up to 3 percent of its costs through greater efficiency, the report’s authors said.

“New Jersey Medicaid is at a critical juncture,” said Linda Schwimmer, president of the Quality Institute. Improvements can be made by integrating mental-health and addiction services with primary care, allowing some medical consultations to take place via telephone, and ensuring the accuracy of the provider directories used by the program’s five managed-care companies, she said.

The report also called for more transparency in data about the program’s services and expenditures, and reforms to the reimbursement and payment system.

State spending on Medicaid accounts for about 20 percent of the state budget. Medicaid spends about $15 billion annually in New Jersey, with two out of three dollars from the federal government. The program insures two out of five children in the state, nearly one-third of the residents of Passaic County and one-eighth of the residents of Bergen County.

While the largest portion of enrollees are children, the greatest expenditures are for long-term care of the elderly and services for the disabled.

“The blueprint can be used by policymakers to make the structural and clinical changes necessary to strengthen and sustain Medicaid over the short and long term,” said Joan Randell, The Nicholson Foundation’s chief operating officer.