NJ FamilyCare’s Perinatal Episode of Care program, a three-year pilot to test a new alternative payment model for prenatal, labor and postpartum services statewide, was announced Friday by first lady Tammy Murphy and Department of Human Services Commissioner Sarah Adelman.
The pilot’s goal is to improve maternity care by encouraging NJ FamilyCare obstetrical providers to broadly engage in all aspects of their patient’s care beyond direct obstetrical care, from pregnancy through the postpartum period, including emergency room visits and newborn pediatric care. Clinicians who choose to participate in the program are financially incentivized to take on comprehensive responsibility for the quality and cost of their patients’ care.
In addition to becoming eligible for financial incentives, providers who participate in the pilot will receive detailed personalized feedback on their performance and will undertake specific quality improvement activities.
More than a dozen NJ FamilyCare providers — which collectively provide maternity care for a third of NJ FamilyCare-covered births each year — have committed to this initiative, which is projected to continue through June 2025 (they are listed at bottom).
New Jersey is one of the first states in the nation to develop a perinatal episode of care and incorporate groundbreaking focus on high-quality maternity care and equitable health outcomes. Murphy, who has made the issue a key focus, said the pilot program is part of New Jersey’s continued commitment to making New Jersey the safest and most equitable state in the nation to deliver and raise a baby.
“The NJ FamilyCare pilot program, launched in partnership with the New Jersey Department of Human Services, will bring us one step closer to reaching Nurture NJ’s goal of reducing our state’s maternal mortality by 50% over five years and eliminating racial disparities in birth outcomes,” Murphy said.
“Coordinating and ensuring effective, quality perinatal care is vital to ensuring a safe and healthy pregnancy, labor and delivery for a mother and her baby. This groundbreaking program is a welcome addition to the many ongoing efforts we have in place to make New Jersey the safest, most equitable state in the nation to deliver and raise a baby.”
Clinicians who volunteered to participate in the program are eligible to share in savings from more efficient perinatal care delivery. Also, the program will send additional incentive payments to providers who hit milestones on critical cost, quality and other metrics.
NJ FamilyCare is New Jersey’s Medicaid and Children’s Health Insurance Program, or CHIP, program, and it covers approximately 30,000 New Jersey births each year.
The pilot addresses a major recommendation in the Nurture NJ Maternal and Infant Health Strategic Plan, a roadmap to make New Jersey the safest and most equitable place in the nation to deliver and raise a baby. The recommendation was for DHS to institute a perinatal episode of care to ensure coordination of services in the months prior to and after delivery to link families to the tools and resources they need to carry out recommended care plans.
Compared to similar programs in other state Medicaid programs, New Jersey’s perinatal episode of care is focused specifically on supporting high-quality maternity care with a focus on addressing health disparities. Obstetrical practices who chose to participate in this voluntary pilot program will receive data on the quality of care their patients receive broken down by the NJ FamilyCare member’s race and ethnicity.
Adelman said New Jersey is determined to do things differently to improve outcomes.
“In New Jersey and across the nation, we will not improve systemic inequities in maternal and child health care and outcomes by doing the same things we always have,” she said. “This pilot program provides clinicians with additional data and financial incentives that will allow them to provide more innovative approaches in care.”
Participating obstetrical practices partnering with NJ FamilyCare for the first period of the pilot include:
- AtlantiCare Physician Group – OB/GYN (Egg Harbor Township)
- Axia Women’s Health (Voorhees)
- Capital Health Regional Medical Center (Trenton) and Capital Health Medical Center (Hopewell Township)
- Cooper University Health Care (Camden)
- Hackensack University Medical Group (Hackensack)
- Inspira Health Network Medical Group (Glassboro)
- James Kusnierz P.A. (Irvington)
- Kennedy Medical Group Practice (Jefferson Medical Group New Jersey) (Voorhees)
- Lifeline Medical Associates LLC (Florham Park)
- Joseph’s Health (Paterson)
- Peter’s University Hospital (New Brunswick)
- The Combined Medical Group of RWJBarnabas Health and Rutgers Health (West Orange)
- Tulip OBGYN LLC (Paterson)
- University Hospital (Newark)
- Virtua Medical Group (Marlton)
- Woman’s Comprehensive Healthcare of N.J. (West Long Branch)