Reprinted from NJ.com
Rose Duger/For The Jersey Journal

A new insurance plan has entered the Hudson County health care marketplace aiming to capitalize on efficiencies and emphasize preventive care to curb rising medical costs.

CarePoint Health Plans is a Medicare Advantage plan offered through Hudson Holdco Inc., the for-profit system that owns Christ Hospital in Jersey City, Bayonne Medical Center and Hoboken University Medical Center.

Launched late last year, it enrolls several hundred subscribers, according to the CEOs of the three hospitals who say the new insurance offering is a response to the inability of fee-for-service plans to stem rising health costs.

“If you take a look at health care in general, the current model of fee-for-service is not tenable,” said Mark Spektor, the president and chief executive officer of Bayonne Medical Center who is also a medical doctor. “The real way to think about health care in the future is that it will be vertically integrated. It will all be rolled into an efficient delivery system.”

To achieve that, CarePoint enrolls all three Hudson Holdco hospitals, as well as satellite testing and care facilities, nursing homes and 90 percent of the health system’s physicians. The CEOs note that the other 10 percent of physicians serve non-Medicare patients such as children and pregnant women.

Monitoring Care

One of only two insurance plans in the state in which a health care provider also serves as an insurer, CarePoint Health Plans promotes preventive care by assigning a case manager and a nurse practitioner to each enrolled patient to monitor care and ensure they participate in preventive services. The plan compensates physicians based on performance, which includes emphasizing preventive care.

The PPO — Preferred Provider Organization — allows patients to pay a higher fee to choose out-of-network providers.

An integrated medical records system provides instant access to each patient’s information including medications, allergies, imaging studies, test results and other procedures to all providers within the plan via smart phones or computers.

“This is 180 degrees different than current insurance models,” Peter A. Kelly, president and chief executive officer of Christ Hospital, said. “Right now, insurers provide incentives to intervene late. We provide incentives to intervene at the earliest onset of a condition, which is economically more feasible. It’s a very patient-centered approach that emphasizes high quality care at a lower cost.”

While this insurance model is relatively new in New Jersey, it has proven to be successful in other parts of the country, Paul A. Walker, president and chief executive officer of Hoboken University Medical Center, said.

“There are multiple models around the country that have succeeded with this three-legged stool, in which there are hospitals that provide physicians and insurance,” he said, noting that a key goal is to keep patients out of the hospital whenever possible. “As things start to shift or align, hospitals are able to keep more patients out of hospital beds and still maintain their financial revenue to balance the whole portfolio. Then we can do the right things in terms of patient care.”

Approved in 2012

The state Department of Banking and Insurance approved CarePoint back in February 2012, according to Ed Rogan, the department’s spokesman. The federal government is also required to give its OK, Rogan said.

Insurance programs sponsored by hospitals are “relatively new, but it’s not the first one that we saw,” he said.

The three Hudson Holdco executives pointed out that for-profit hospital systems are well-positioned to pioneer this relatively new model of health insurance because of the emphasis on efficiency and self reliance.

“If you take a look at cost, the infrastructure in not-for-profits is enormous. They have to rely on the state and federal governments to bail them out,” said Kelly, who spent the majority of his career in the not-for-profit sector. “The big difference here in Hudson County is that we’ve taken a huge burden off the state. All three of our hospitals no longer rely on state stabilization dollars. And we pay millions to the municipalities in taxes.”

Kelly added that Christ Hospital, which was purchased by Hudson Holdco last July, provides more charity care than a year ago; in January those patients will have insurance under the federal Affordable Care Act.

While Hurricane Sandy affected the plan’s first cycle of open enrollment last fall, the CEOs expect a brisker response this year as word gets out about the plan and more patients are eligible to apply under Medicaid.

“We’re confident that this is going to be a good year,” Spektor said.

Journal staff writer Terrence T. McDonald contributed to this report.

Pictured left to right: Dan Atillo, President of the United Way of Hoboken; Paula A. Nevoso, Vice President of the CarePoint Health Foundation; Paul Walker, President and CEO of Hoboken University Medical Center; Peter Kelly, President and CEO of Christ Hospital; and Dr. Mark Spektor, President and CEO of Bayonne Medical Center.

Previously reported in the December 18, 2012 edition of the Hudson Reporter Newspaper.

HUDSON COUNTY AND BEYOND — The CarePoint Health Foundation presented the United Way of Hudson County with a $25,000 check on Monday, December 17th. Paul Walker, President and CEO of Hoboken University Medical Center; Peter Kelly, President and CEO of Christ Hospital in Jersey City; and Dr. Mark Spektor, President and CEO of Bayonne Medical Center, presented the check to Dan Altilio, President of the United Way of Hudson County to aid local victims of Hurricane Sandy. The presentation was held at Hoboken University Medical Center, where it was also announced that their radiology group has made a $2,500 donation in addition to the presented check.

“We have an obligation to the communities we serve to respond during times of crisis,” said Dan Kane, President of the CarePoint Health Foundation. “Many of our residents have been impacted by Hurricane Sandy and relief efforts through philanthropic dollars are one way for us to help.”

Christ Hospital is open and accepting all patients, and is no longer on generator power. We are resuming general visiting hours beginning at 9:00 am on Saturday, November 3rd. However, visiting hours will end at 5:30 pm.

Department of Health and Senior Services Commissioner, Mary E. O’Dowd commends the clinical and hospital staff of Christ Hospital for their ongoing efforts to provide for the needs of the community before, during, and after the latest weather event, Hurricane Sandy.

Commending the clinical and hospital staff for their efforts in caring for patients before, during, and after Hurricane Sandy, Mary E. O’Dowd, Commissioner of the New Jersey Department of Health and Senior Services visited Christ Hospital earlier today to assess the current situation at the hospital.

The commissioner toured with representatives from the hospital through different areas of the facility including the Emergency Department, Intensive Care Unit and the Emergency Operations Center. Sensitive to the needs of the staff and their ability to continue to provide the much needed healthcare services to the community, Ms. O’Dowd offered any assistance necessary the State could afford to help the hospital in Sandy’s wake.

Peter A. Kelly, President and CEO of Christ Hospital stated, “Knowing that the State of New Jersey supports our efforts to continue to provide for the care of the residents of the community is reassuring. We will continue our efforts to collaborate with other hospitals in Hudson County to provide access to care for those in need.”

With the suspension of services provided by the major hospital Emergency Departments in the area, Christ Hospital has remained open and able and ready to provide uninterrupted emergent and acute care to the residents of Hudson County throughout the course of this entire weather event.

To Prepare for an incident of this magnitude, the staff of Christ Hospital has been coordinating emergency drills with the Federal and State Offices of Emergency Management over the past several years. An Emergency Operations Center (EOC) was established at the hospital to serve as the backbone for relaying communications between State and local emergency agencies and was instrumental in coordinating staff, supplies, and services to patients. Christ Hospital was one of the first hospitals in the area to set up its EOC on Sunday morning, well in advance of this storm. Staff from the hospital has been working around-the-clock to make sure vital services are always available and running at optimal efficiency.

Compensating for the anticipated large influx of patients to the Emergency Department, other sections of the hospital were converted to temporary Emergency Triage staging areas.  During the course of late Sunday evening, coordination efforts with Hoboken University Medical Center facilitated the safe transfer of forty patients to Christ Hospital. At no point during the transfer was the care of the patients ever compromised.

Since the onset of the storm, the Emergency Department has provided care to over 897 patients, of which, over 161 were admitted to inpatient units. The only time the hospital had to divert patients from the Emergency Room was on Wednesday afternoon for approximately one hour after Jersey City Medical Center was forced to divert ambulances briefly for a second time. This resulted in Christ Hospital receiving over seventeen ambulances at once.

The benefit of being part of a three-hospital network, which includes Christ Hospital, Hoboken University Medical Center, and Bayonne Medical Center, was immediately apparent. Once Hoboken University Medical Center made the decision to close, arrangements were made to have pharmaceutical supplies and oxygen canisters transferred to Christ Hospital to replenish quickly depleting supplies. Directors at Christ Hospital were able to coordinate logistic measures with their counterparts at Bayonne Medical Center to replenish much-needed supplies and coordinate care for patients.

The hospital provided services to a multitude of individuals including one Code Stroke patient. The Labor and Delivery unit delivered twenty-seven babies, and hemodialysis was provided to twenty-one patients. Treatment for the hemodialysis patients was coordinated with local private providers at off-site facilities.  The Security Department of Christ Hospital provided transportation for these patients to the facilities. After their treatments were completed, they also provided transportation to their homes later that evening, safely navigating the darkened streets of Jersey City.

The Food Services Department provided over 3,635 meals to patients and their families and 4,450 meals to the staff working at the hospital.

Normal operations continued to take place at the hospital as well. The Transitions In Care Family Clinic opened earlier today. This clinic fulfills a commitment to dispense healthcare services to underinsured/uninsured patients. Outpatient services are provided to these individuals, regardless of their ability to pay. Similar clinics are currently providing services to patients at Hoboken University Medical Center and Bayonne Medical Center also.

Peter A. Kelly, President and CEO of Christ Hospital remarks, “Hurricane Sandy posed a serious and considerable threat to our area and its aftermath continues to offer many new challenges. The location of the hospital, the dedication of our staff, and our ability to be prepared for a disaster of this magnitude, have proven how absolutely vital Christ Hospital is as a key and indispensible component of the healthcare delivery system in Hudson County.”

Because of the aftermath of Hurricane Sandy and to assure the safety of patients’ family members and friends, we are suspending visitations to the hospital until further notice. Exceptions will be made for pediatric patients and those who are critically ill.

We apologize for any inconvenience that may occur as a result of this weather event and we appreciate your patience and understanding.

An annoucnement will be made as to when normal visitation hours will resume. For future updates, please contact 201.795.8619. Thank you.

Because of the impending Hurricane and to assure the safety of patients’ family members and friends, beginning on Monday, October 29th, we are suspending visitations to the hospital until Wednesday, October 31st. Exceptions will be made for those patients who are critically ill.We apologize for any inconvenience that may occur as a result of this weather event and we appreciate your patience and understanding.Normal visitation hours will resume on Wednesday, October 31st.