Matt D’Oria is the chief transformation officer for the New Jersey Health Care Quality Institute, a health care research and advocacy group. He was also deputy commissioner of the New Jersey Department of Health under Jon Corzine. D’Oria is also one of the authors of a new study called Medicaid 2.0. He spoke with NJTV News Correspondent David Cruz about the future of health care.
Cruz: So I guess my biggest curiosity is what impact do you expect from yesterday’s announcement from congressional Republicans that they’ve got a new health care plan to promote?
D’Oria: Sure, it’s a great question given everything that’s happening in Washington. I’ll start by saying our report really was conceived a year ago before anyone could know what the outcome of the presidential election was going to be and therefore which way the ACA repeal would go. At the time, we were assuming there wouldn’t be repeal but nevertheless our work is about improving the quality and the cost in Medicaid. It is not structurally a refinancing recommendation. As the ACA repeal and replaces that’s all about the financing of Medicaid, this is about the delivery of the services in Medicaid and how they can be done more efficiently yielding higher quality for the beneficiaries.
Cruz: I mean, the biggest question out of that is this talk about block grants to states. What impact do you expect that to have on New Jersey?
D’Oria: A block grant for New Jersey? First, we haven’t seen many of the details. I was just looking at the bill a little bit before the interview and they have some base provisions in there, but it’s hard to estimate what the impact of that will be. But I think it’s suffice to say that block grants historically have limited states’ funding. It’s been a way for the federal government to assure themselves continuity in terms of projecting their budget but it also poses some extra burden on states that have to live with that fixed allotment.
Cruz: Let’s talk about some of your recommendations. Give me something that is a short-term fix that anybody who is running government in New Jersey can do.
D’Oria: Well, I’ll start at the top of our list. We are recommending something called the Office of Health Care Transformation. This is modeled on Gov. [John] Kasich’s model in Ohio where he pulled together some key staff from his congressional office 18 months before he ran for office and said, “Look I’m going to run for governor and I want to make sure I have a game plan for Medicaid.” And so this office was formed once he was elected and it has oversight for all strategic and financial health care decisions in Ohio. We’re recommending a similar approach here in New Jersey. We’ve got multiple cabinet departments involved in Medicaid — Human Services, Health, Children and Families, the Treasury Department, Education. So having someone at the governor’s office level who has that perspective is not siloed in those various agencies and can see across those agencies we think is actually instrumental in making the rest of the recommendations work because that perspective is critical to ensuring success.
Cruz: You have a Republican administration on the federal level and what looks like it may be a Democratic administration coming on the state level. And certainly the Legislature is controlled by the Democrats. What difficulty, do you think there will be the political will necessary on both sides to come to some of these recommendations?
D’Oria: Sure, let me take a step back and say how the report was generated and it helps address the question you just posed. When we started, we wanted it to be an organic effort, meaning we wanted the stakeholders to come together and tell us what could work in the Medicaid program. So we had health plans, state officials, advocacy groups, health providers as well as legislative staff come to meetings, talk to us about what was working in Medicaid, what wasn’t working in Medicaid and how it could be improved. So in that way these recommendations have already been vetted by the various constituencies you’re alluding to in that they’ve sat at the table with us and endorsed the recommendations.
Cruz: All right, changes needed, changes coming. Matt D’Oria, thanks for taking the time.
D’Oria: Thank you very much, David.