CMS Awards Millions to Test APM

Hackensack Meridian Health’s award from CMS for $15.8 million to https:///www.HackensackMeridainHealth.org,  to implement the New Jersey Integrated Care for Kids (InCK) Model to test the APM https://innovation.cms.gov/initiatives/integrated-care-for-kids-model for the Medicaid program https://qpp.cms.gov/apms.

According to Thomas Thees, Executive Director, for VNA of Central Jersey http://vnacj.org, “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 are dictated by individual municipalities.”

He adds, “By working with Hackensack Meridian Health and the Quality Institute, we will be able to break down some of the silos to better integrate resources to improve the care for the state’s most vulnerable children.”

The Medicaid program supports multi-sectoral integrated care management and pediatric practice capacity building in Monmouth and Ocean counties in New Jersey. The new Payment Model will address improving care for pediatric patients with complex medical conditions.

Hackensack Meridian Health, the administrative lead organization is partnering with co-lead organizations, to include the VNA of Central Jersey https://www.vnacj.org, the New Jersey Medicaid Agency, and the New Jersey Health Care Quality Institute (Quality Institute) https://njhcqi.org. Only eight awards were issued by CMS across the country and the one awarded to Hackensack Meridian Health, the VNA, and Quality Institute was the only one given in New Jersey.

Hackensack Meridian Health will also partner with the VNA and the Partnership Council (PC) to monitor and execute the model. Also, the state’s Medicaid Office, Hackensack Meridian Health, and the Quality Institute will work collaboratively to design and implement the APM.

The goal is to identify children and adolescents who are covered under New Jersey Medicaid, who have higher than average health issues as indicated by a combination of factors including medical, behavioral, and social risks.

Once the children are identified, the aim is to improve their outcomes, reduce emergency room use, inpatient admissions, and out-of-home placements for escalated behavioral needs and substance use disorders, by providing integrated care coordination and case management. If children are at lower risk for health and social issues, they also will be able to receive care and benefit from visits to primary care offices.

 

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