Panelists to tackle how to tame health care costs – NJBIZ

ReNew Jersey Business Summit

Schwimmer

As a small employer, Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute, understands the importance of providing comprehensive health insurance to employees. But the nonprofit organization — which has more than 120 members from every segment of the health care industry in the state, and advances health care safety, quality and affordability — recently saw a 13% increase in its own health care premiums.

“Unfortunately, New Jersey’s small employer market is in danger, as steep declines in enrollment and rising premiums are leading employers to leave the market,” said Schwimmer, who will sit on the health care panel during the New Jersey Chamber’s ReNew Jersey Business Summit.

“In turn that worsens the overall situation. Doing nothing will lead to the collapse of the market. We released a white paper with suggestions to improve the market that could be done by the state now.”

The recommendations, which include increasing availability and transparency of data on where employees of small employers are getting health care coverage and removing the state’s requirement for health plans to sell in both the small group and the individual market, are mostly “short term fixes,” she added. “Over the longer term, however, it comes down to costs — costs at every level. If we don’t get our arms around the costs, they will continue to rise at a faster rate than wages and earnings. What we need now is the will to say, as a society, that we must spend less on health care.”

New Jersey officials can help, she added. To start, the state “can enact some or all the proposals in the Quality Institute’s white paper.” One suggestion: providing a state-based tax credit to small employers — traditionally defined as those with 50 or fewer full-time employees — who offer plans that are fully compliant with New Jersey and ACA regulations.

“This tax credit could assist employers who are not required to provide insurance to their employees but choose to provide coverage,” said Schwimmer. “The credit could vary over time depending on the availability of funds to support such a subsidy or can come from a designated fund or general funds. For reference, there are over 164,000 small employers in New Jersey who could benefit from such a credit.”

Even debating the issue is important, she added, “because it brings attention to the issue and gets people asking: Why do we spend so much; are there changes we can make? Another important area is focusing on how we spend our health care dollars. Are we placing an emphasis on primary and preventive care and high-value care? These are changes that won’t save money today but will lead to better use of health care funds. Other developed countries spend more on primary care and have better health outcomes.”

Affordability and accessibility

Lazarus

“The life sciences industry played a key role in the fight against COVID, literally saving countless lives – with much of that innovation stemming from New Jersey,” according to panelist Wendy Lazarus, interim vice president of government affairs at BioNJ. “As COVID-19 evolves, the biopharmaceutical industry will continue to strategically collaborate to develop new vaccines and treatments to protect our communities.”

BioNJ, for example, initiated and partnered with the New Jersey Health Care Quality Institute to bring together experts from all sectors of the healthcare ecosystem to develop ‘Emerging From COVID-19: An Action Plan for a Healthier State.’ But affordability of and accessibility to health care are at top of mind every day, she added.

“BioNJ’s Membership continues to help ensure that patients have access to the treatments they need when they’re needed most, whether through patient assistance pro-grams or the nearly $200 billion in rebates paid by industry members each year to lower patient costs.”

According to a new analysis by the Berkeley Research Group, however, “nearly 50 cents of every $1 spent on brand medicines went to middlemen and payers – not to the patients nor to the biopharmaceutical company that developed and manufactured the medicine,” said Lazarus.

“Recognizing the complexity in developing effective policies to improve Patient affordability, BioNJ believes that passing through a substantial portion of rebates at the point of sale is an important step to ensuring that patients directly benefit from the significant price negotiations taking place in the health care market. BioNJ is committed to working with Gov. Murphy and our New Jersey Legislature to implement solutions that allow for transparency across the entire supply chain and reduce patient out-of-pocket costs while supporting future innovation.”

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