Southern New Jersey Market Overview

Analyst: April Wortham

Report Summary:
Southern New Jersey healthcare providers are dabbling in innovative care delivery and payment models that reward efficiency and improved patient outcomes rather than volume of services provided. However, health systems and physicians in the market continue to face a challenging reimbursement environment characterized by a high cost of living, expensive malpractice insurance and low reimbursements from Medicaid and private payers. In an effort to lower costs, some managed care organizations have begun offering insurance products that only allow members to use providers who have in-network contracts with health plans. It remains to be see how such plans will be received by Southern New Jersey employers, who continue to push more costs on to employees, cut benefits or drop coverage altogether.

Questions Answered In This Report:
Despite a poor economy, health systems and hospitals in Southern New Jersey are expanding both facilities and services in hopes of preventing patients from traveling outside the market for care.  Which health systems are building outpatient facilities and where? Which health system has an agreement with physicians of Children’s Hospital of Philadelphia to provide pediatric services in Southern New Jersey? Which health system is expanding cancer treatment options for residents of Southern New Jersey?

Faced with rising costs and shrinking reimbursements, an increasing number of Southern New Jersey physicians are seeking employment by health systems and hospitals. Which health systems are most aggressive in purchasing physician practices? Which health system is building a network of primary-care physician practices? Which physician group is set to play a major role in the development of a new four-year medical school in Southern New Jersey?

In an effort to exert more control over provider reimbursements, managed care organizations in Southern New Jersey are poised to expand pilot projects that include medical homes and bundled payment initiatives. Which MCO’s subsidiary recently launched New Jersey’s first statewide patient-centered medical home pilot? Which health plans are poised to see a bump in enrollment as the state shifts some 196,000 aged, blind and disabled Medicaid beneficiaries into managed care? Which New Jersey employer coalition launched its own self-funded health plan for its membership?

Metrics:
Key market indicators and leading organizations among health systems, physicians and health plans
Health systems’ market share
Income, revenue, enrollment and pharmacy spend for leading health plans
Demographics

Market Includes
 Southern New Jersey, which includes the counties of Burlington, Camden and Gloucester
 
Primary Research
 Analysis of HealthLeaders-InterStudy data, Billian’s HealthDATA, local and state news and industry reports and interviews with local healthcare executives

Companies Mentioned:

• Virtua
• Kennedy Health System
• Lourdes Health System
• The Cooper Health System
• Cooper University Physicians
• Virtua Medical Group
• Lourdes Medical Associates
• Aetna
• UnitedHealth Group
• Horizon Blue Cross Blue Shield of New Jersey
• New Jersey Business & Industry Association
• Delaware Valley Health Care Coalition
• Chamber of Commerce Southern New Jersey 
• New Jersey Business Group on Health
• Employers Association of New Jersey
• The New Jersey Main Street Alliance
• Health Care Payers Coalition of New Jersey