Caucus Up Close: Rainier Aquino, MD; Bob Marino, Veronica Ray

Caucus Up Close: Rainier Aquino, MD; Bob Marino, Veronica Ray


I’M RODGER DEROSE, AT KESSLER FOUNDATION WE’RE COMMITTED TO CHANGING THE LIVES OF PEOPLE WITH DISABILITIES THROUGH RESEARCH, AND EMPLOYMENT STTRATEGIES, AND THAT’S WHY WE’RE PROUD TO SUPPORT PROGRAMMING PRODUCED BY THE CAUCUS EDUCTAIONAL CORPORATION, AND THEIR PARTNERS IN PUBLIC TELEVISION. FUNDING FOR THIS EDITION OF CAUCUS NEW JERSEY HAS BEEN PROVIDED BY THE PNC FOUNDATION, WHICH SUPPORTS EARLY CHILDHOOD EDUCATION THROUGH GROW UP GREAT, A MULTI-YEAR INITIATIVE TO HELP PREPARE CHILDREN FROM BIRTH TO AGE 5 FOR SUCCESS IN SCHOOL AND LIFE, THE NEW JERSEY EDUCATION ASSOCIATION, NJIT, NEW JERSEY INSTITUTE OF TECHNOLOGY, PSE&G COMMITED TO IMPROVING NEW JERSEY’S ECONOMY AND STRENGTHING IT’S COMMUNITIES, KESSLER FOUNDATION, CHANGING THE LIVES OF PEOPLE WITH DISABILITIES, ADLER APHASIA CENTER HELPING STROKE AND BRAIN INJURY SURVIVORS RECOVER THEIR SPEECH, AND BY NEW JERSEY SHARING NETWORK, DEDICATED TO SAVING LIVES THROUGH ORGAN AND TISSUE DONATION, [MUSIC] [MUSIC]>>HI I’M STEVE ADUBATO, REALLY IMPORTANT SUBJECT WE’RE GUNNA BE TALKING ABOUT TODAY, WITH THE GENTLEMEN YOU’RE ABOUT TO SEE ON CAMERA, DOCTOR RAINIER AQUINO CARDIO- EXCUSE ME, A VASCULAR SURGEON, MERIDIAN CARDIOVASCULAR NETWORK, JERSEY COAST VASCULAR INSTITUTE, DOCTOR WE WERE JUST TALKING ABOUT THIS RIGHT BEFORE WE GOT ON THE AIR THIS SUBJECT OF ANEURYSMS, HUGE TOPIC, AFFECTS MILLIONS OF AMERICANS AND LITTLE UNDERSTOOD, NOW I TELL YOU I HAVE SOME FAMILY HISTORY HERE THAT- I’M NOT GUNNA TALK ABOUT ON THE AIR- BUT I’M NOT ALONE, TALK ABOUT THIS ISSUE.>>WELL, FIRST AN ANEURYSM IS A DISORDER WHERE YOUR NORMAL BLOOD VESSEL STARTS TO BALLOON OUT, OR BULDGE OUT AND EXPAND AND THE POTENTIAL IS THAT WHEN IT CONTINUES TO EXPAND IT CAN BURST, AND IF IT BURSTS YOU KNOW YOU CAN HAVE SEVERE INTERNAL BLEEDING AND THAT CAN LEAD TO MORTALITY, LETHAL ISSUES WITH THAT, AND IT’S A COMMON DISORDER, IT AFFECTS AMERICANS ONE POINT FIVE TO TWO MILLION AMERICANS IN THIS COUNTRY TWO HUNDRED THOUSAND CASES ARE DIAGNOSED BY PHYSICIANS EVERY YEAR, OF WHICH FIFTEEN THOUSAND ARE POTENTIALLY LETHAL, BECAUSE IT CAN BURST SO IT’S SOMETHING THAT’S FAIRLY COMMON, ALSO TENTH LEADING CAUSE OF SUDDEN DEATH IN MALES OVERALL IN THIS COUNTRY IN MALES…>>WHY MORE MEN THAN WOMEN?>>NO ONE REALLY KNOWS WHY? BUT GENERALLY FOR THE MALE POPULATION IT AFFECTS ABOUT TWO TO FIVE PERCENT OF MALES OVER THE AGE OF SIXTY SO THAT BECOMES A RISK FACTOR MALES HAVE A FOUR TIMES MORE RISK OF DEVELOPING THESE ANEURYSMS ALTHOUGH OVERALL ANEURYSM POPULATION ABOUT TWENTY PERCENT ARE FEMALES OTHER RISK FACTORS SUCH AS SMOKING, SMOKERS HAVE A SEVEN TIME INCREASE RISK OF DEVELOPING THESE ANEURYSMS…>>SMOKERS?>>SMOKERS, THOSE FORMER SMOKERS HAVE A FOUR TIME INCREASE RISK, AND ALSO IMPORTANT IS FAMILY, THERE’S A TWENTY PERCENT GENETIC LINK WITH FAMILIAL FAMILY MEMBERS IF YOU HAVE A FATHER, A MOTHER, A BROTHER YOU SHOULD FIND A BOARD CERTIFIED VASASURGEON AND BE EVALUATED FOR THESE ANEURYSMS, AND ANEURYSMS AGAIN CAN AFFECT ANY BLOOD VESSELIN THE BODY FROM THE BRAIN, THE LEGS, MORE COMMONLY IT AFFECTS THE LARGEST BLOOD VESSEL IN THE BODY, AND THAT’S IN THE CHEST OR ABDOMEN.>>THE CHEST OR ABDOMEN. LET TALK THIS THROUGH, CAN WE GET A SHOT OF THIS TEAM, LET’S TAKE A LOOK, DOCTOR AQUINO HELP OUR TEAM MAKE SENSE OF THIS, BECAUSE WITHOUT YOU TALKING ABOUT IT WE’RE NOT GUNNA BE ABLE TO DESCRIBE WHAT WE’RE LOOKING AT RIGHT NOW.>>THE LARGEST BLOOD VESSEL IN THE BODY IS THE AORTA, AND THIS IS THE AORTA WHICH IS IN THE ABDOMEN, ITS PURPOSE IS TO GIVE BLOOD TO THE LOWER EXTREMITIES, LOWER PART OF THE BODY, AND THE ABDOMINAL VISCERA, WHEN TYPICALLY THE SIZE OF THE AORTA’S ABOUT AN INCH, ABOUT TWO CENTIMETERS, WHEN ITS- A SEGMENT OF THE BLOOD VESSEL GETS DISEASE IT STARTS TO BULDGE OUT AND EXPAND AND THIS IS WHAT’S KNOWN AS AN ANEURYSM, WHEN IT EXPANDS MORE THAN IT’S SAFETY MARGINS THEN IT BECOMES A CRITICAL HEALTH RISK BECAUSE THESE CAN OBVIOUSLY AS YOU CAN SEE IN THIS IT CAN BURST…>>NOW WHAT ARE WE LOOKING AT RIGHT HERE DOCTOR?>>AT THE LEVEL OF YOUR BELLY BUTTON THIS IS WHERE YOUR ARTERY SPLITS INTO THE LEFT AND RIGHT ILIAC ARTERIS THAT PROVIDE BLOOD FLOW TO YOUR LOWER EXTREMITIES.>>GOT IT…>>OKAY…>>SO LET ME ASK YOU THIS, THE BIGGEST DANGER HERE IS THAT IF SOMEONE DOESN’T MONITOR, SOMEONE’S NOT AWARE THAT THEY HAVE A POTENTIAL PROBLEM, OR AN ANEURYSM IN THIS AREA, AND IT BURSTS CAN YOU DEAL WITH IT, OR IS THAT IT?>>THERE’S POOR SURVIVAL IN THAT SITUATION…>>WHY?>>WELL IT’S MASSIVE BLOOD LOSS INTERNALLY, THEY MAY NOT THINK THAT IT’S AN ANEURYSM, BUT IT’S ABDOMINAL PAIN AND BACK PAIN AND BY THE TIME THEY GET TO THE EMERGENCY ROOM AND THEN THE OPERATING ROOM, IT MAY BE TOO LATE, SO PATIENTS CAN EXPERIENCE SEVERE BACK PAIN AND ABDOMINAL PAIN ASSOCIATED WITH SHOCK, LOSS OF CONSCIENCE, YOU KNOW, DIZZINESS, ALL THOSE CAN OCCUR IN THAT EMERGENT SETTING AND THEY HAVE TO GET THEM TO THE HOSPITAL AS SOON AS POSSIBLE…>>YOU KNOW WHAT’S INTERESTING ABOUT THIS IS I ALSO THINK ABOUT PREVENTION, OKAY I MENTION TO YOU- WITHOUT GOING INTO A LOT OF DETAIL THAT A DOCTOR HAD PICKED UP SAID YOU HAVE A MICROSCOPIC ANEURYSM AND IT WASN’T IN THAT SPOT FOR ME IT WAS MORE IN A LEG AREA HE SAID, I SAID OH OKAY, HE SAID I WANT THIS CHECKED OUT HE WAS VERY SPECIFIC ABOUT WHAT HE WANTED DONE, BUT IN ALL CANDOR, UNTIL I WAS GETTING READY FOR THIS SHOW I WASN’T THINKING ABOUT IT MUCH, NOW YOU HAVE ME THINKING ABOUT IT A LOT, I’M THINKING WELL WHAT TO YOU DO IS THERE MEDICATION? LIKE SAY IT’S THE RIGHT PHYSICIAN THE RIGHT CIRCUMSTANCE, WHAT HAPPENS?>>THERE IS NO MEDICATION IT’S NOT GOING TO GO AWAY IT’S NOT GOING TO STAY, YOU KNOW WHERE THE SIZE THAT IT’S AT, IT’S GUNNA CONTINUE TO GROW IN THIS AREA…>>CAUSE THAT’S WHAT ANEURYSMS DO?>>PRETTY MUCH WHAT IT DOES THERES A WEAKENING IN THE WALL AND IT’S GUNNA CONTINUE TO EXPAND AND EXPAND UNTIL IT CAN’T EXPAND ANYMORE AND THAT’S WHEN YOU HAVE, YOU KNOW, WHEN IT BURSTS OR RUPTURES, SO IN GENERAL IN THE ABDOMINAL AORTA IT GROWS ABOUT FOUR MILIMETERS A YEAR, AND SO IT’S IMPORTANT AND THAT’S KEY TO CONTINUE WITH YOUR PHYSICIAN TO MONITOR its GROWTH, WHETHER IT’S A SIX MONTH ULTRASOUND, YEARLY ULTRASOUND, YOU CONTINUE TO MONITOR its GROWTH, UNTIL IT NEEDS TO BE FIXED, AND GENERALLY IN THIS AREA…>>DEFINE FIX…>>THAT’S ABOUT FIVE CENTIMETERS.>>FIX>>SO WHEN WE FIX IT, IT’S EITHER TWO WAYS, THERE’S THE TRADITIONAL SURGERY WHICH IS THE BIG INCISION IN THE ABDOMEN, AND WE REPLACE THIS SEGMENT BY HAND WITH THIS DURABLE MAN MADE TUBE LIKE STRUCTURE, THAT’S OVERTIME 90 PERCENT SUCCESFUL, NOW THE RECOVERY IN THE TRADITIONAL APPROACH IS A LOT LONGER, YOU KNOW, A PATIENTS GENERALLY GO THROUGH A LOT DEPENDING ON THEIR CIRCUMSTANCE, DEPENDING ON THEIR CO MORBID RISK FACTORS, THE NEWER APPROACH, THIS HAS BEEN AROUND FOR ABOUT TWENTY, TWENTY-FIVE YEARS NOW IS FIXING IT, NOT FROM THE OUTSIDE AS WE WOULD WITH A TRADTIONAL APPROACH, BUT FROM THE INSIDE AS DIPICTED IN THIS, YOU KNOW, FIGURE THIS MODEL WHERE WE WOULD MAKE TWO SMALL INCISIONS INSTEAD IN THE GROIN AND DEPLOY THIS STINT GRAPH FROM THE INSIDE WITH LIVE XRAY>>RECOVERY THERE?>>GENERALLY RECOVERY IS ONE DAY…>>REALLY?>>AT LEAST IN OUR PRACTICE WE SEND OUR PATIENTS HOME IN ONE DAY BUT BASE LINE QUALITY OF LIFE RETURNING TO FUNCTION IS ABOUT FOUR WEEKS…>>YOU CAN’T IGNORE THIS STUFF…>>RIGHT, BUT OVERALL THERE THOSE ARE THE TWO OPTIONS FOR ADDRESSING THESE ANEURYSMS.>>ANEURYSMS CAN NOT BE IGNORED, YOU CAN NOT CURE IT BUT YOU CAN MONITOR IT AND STAY ON TOP OF IT, CORRECT?>>YES>>DOCTOR AQUINO VASCULAR SURGEON AT MERIDIAN CARDIOVASCULAR NETWORK JERSEY COAST VASCULAR INSTITUTE, THANK YOU DOCTOR FOR JOINING US, APPRECIATE>>THANK YOU IT, IMPORTANT MEDICAL INFORMATION, HEALTH INFORMATION STAY WITH US. [MUSIC] TO SEE MORE CAUCUS NEW JERSEY WITH STEVE ADUBATO PROGRAMS VISIT US ONLINE AT STEVEADUBATO.ORG IF YOU WOULD LIKE TO EXPRESS AN OPINION EMAIL US AT [email protected] FIND US ON FACEBOOK AT FACEBOOK.COM/STEVEADUBATOPHD AND FOLLOW US ON TWITTER @STEVEADUBATO>>WE’RE PLEASED TO WELCOME OUR FRIEND BOB MARINO CHAIRMAN AND CHIEF EXECUTIVE OFFICER HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY BOB GOOD TO SEE YA>>GOOD TO SEE YOU STEVE, GOOD TO BE HERE>>WE FULLY DISCLOSE- WE WANT TO FULLY DISCLOSE THAT YOU WERE A MEMBER OF THE BOARD OF PUBLIC TELEVISION IN THE STATE OF NEW JERSEY BUT WE’RE NOT HERE TO TALK ABOUT PUBLIC TELEVSION WE’RE HERE TO TALK ABOUT THE CHANGING LANDSCAPE OF HEALTHCARE, BOB WE OFTEN TALK ABOUT REMOVING FROM WHAT WAS CALLED FEE FOR SERVICE TO A MORE QUOTE “PATIENT CENTERED CARE MODEL” I’M ASKING MYSELF HAVEN’T WE ALWAYS DONE THAT? OR WHAT’S DIFFERENT? TALK TO US.>>SURE, WELL YOU’RE RIGHT STEVE, WHAT WE’RE DOING AND WHAT HORIZON’S COMMITED TO DOING IS REALLY CHAINGING THE WAY HEALTHCARE’S DELIVERED AND PAID FOR IN THE STATE OF NEW JERSEY TODAY HEALTHCARE’S DELIVERED AND PAID FOR IN NEW JERSEY AS IT IS THROUGHOUT THE COUNTRY ON SOMETHING CALLED A FEE FOR SERVICE SYSTEM, AND AS THE NAME SUGGESTS THE WAY THE REIMBURSEMENT WORKS THE SERVICES OR MORE SERVICES YOU DO, THE MORE REIMBURSEMENT YOU COLLECT FUNDAMENTALLY IT’S NOT A SUSTAINABLE ECONOMIC SYSTEM SO WE NEED TO MOVE TO SOMETHING THAT CREATES MORE VALUE FOR THE HEALTHCARE DOLALR, SO HORIZON IS VERY COMMITED TO TRANSFORMING HOW WE PAY FOR AND DELIVER CARE FROM FEE FOR SERVICE TO WHAT WE CALL FEE FOR VALUE, SO PEOPLE WILL ALWAYS ASK ME, WELL CAN YOU DEFINE VALUE, WHAT DOES THAT MEAN? SO WE DEFINE VALUE THREE WAYS, THE FIRST WAY WE DEFINE IT IS THAT WE HAVE BETTER OUTCOMES AND IMPROVED CARE, THE SECOND THING IS WE HAVE MORE PATIENT INVOLVEMENT, BETTER PATIENT EXPERIENCE WITH THE DELIVERY OF CARE AND THIRD AND IMPORTANTLY WE’RE ABLE TO LOWER THE TOTAL COST OF CARE, SO WHEN WE TALK ABOUT TRANSFORMATION WE WANT TO MOVE FROM THIS UNSUSTAINABLE FEE FOR SERVICE SYSTEM WHICH BASICALLY DOES NOT PROVIDE COORDINATED CARE ESSENTIALLY IT’S AN INFLATIONARY KIND OF SYSTEM TO A SYSTEM THAT REWARDS VALUE, AND AGAIN VALUE BEING DEFINED AS BETTER QUALITY, BETTER OUTCOME, BETTER PATIENT EXPERIENCE, AND LASTLY LOWER TOTAL COST OF CARE>>BOB IT MAKES SENSE LOGICAL, BUT I’M ASKING MYSELF WHAT DOES IT MEAN HAT COULD IT MEAN, FOR PATIENTS ON THE OTHER END OF THIS?>>THAT’S A FAIR QUESTION AND HERE’S WHAT IT MEANS FROM OUR PERSPECTIVE NUMBER ONE, PATIENTS WILL RECEIVE BETTER CARE MORE COORDINATED CARE…>>WHAT DOES THAT MEAN?>>MORE COORDINATED CARE TODAY IN OUR FEE FOR SERVICE SYSTEM CARE IS DELIVERED IN A VERY FRAGMENTED BASIS, I’M CERTAIN YOU KNOW OF STORIES OF FOLKS WHO SEE ONE PHYSCIAN, PHYSCIAN ORDERS A SERIES OF TESTS SEE ANOTHER PHYSICIAN AND ANOTHER SERIES OF TESTS ARE ORDERED, UNCOORDINATED FRAGMENTED CARE, SO WHEN WE TALK ABOUT PATIENT CENTERED CARE WE’RE REALLY TALKING ABOUT A PRIMARY CARE PHYSICIAN, A FAMILY CARE PHYSICIAN, COORDINATING ALL OF THE NEEDED CARE FOR THAT PATIENT SURING THAT THE PATIENT’S GETTING THE CARE IN THE RIGHT SETTING AT THE RIGHT COST AT THE APPROPRIATE TIME IMPORTANTLY WHEN A PHYSICIAN PRACTICES WHAT WE CALL PATIENT CENTERED CARE THEY ACT AS SORT OF LIKE THE COORDINATOR OF THE OVERALL HEALTHCARE FOR ALL OF THE PATIENTS IN THEIR PANEL IF YOU WILL, AND INSTEAD OF JUST GOING IN TO SEE THE DOC BECAUSE YOU’VE GOT YOU KNOW AN ACUTE BRONCHITIS, YOUR DOCTOR WHEN HE’S PRACTICING PATIENT HE OR SHE’S PRACTICING PATIENT CENTERED HEALTHCARE IS REALLY LOOKING OUT FOR YOUR TOTAL WELL BEING MAKING CERTAIN THAT YOU’RE GETTING THE RIGHT PERVENTATIVE CARE AT THE RIGHT TIME, AND ETCETERA AND AS WE’RE ABLE TO TRANSFORM THE DELIVERY SYSTEM TO DO THAT PATIENTS WILL SEE IMPROVED CARE MORE INVOLVMENT WITH THEIR CARE, APPROPRIATE CARE AT THE RIGHT TIME AT THE RIGHT PLACE AND IMPORTANTLY LOWER TOTAL COST OF CARE BECAUSE SERVICES ARE BEING BETTER COORDINATED.>>BOB YOU SAID, AND I’VE TALKED TO ALL YOUR FOLKS THE OTHER THING IS I’VE DONE A LOT OF LEADERSHIP DEVELOPMENT COACHING AT HORIZON, SO I’VE GOTTEN TO KNOW YOUR PEOPLE, ONE OF THE THINGS YOUR PEOPLE TELL ME IS THAT ONE OF THE CHALLENGES THEY FACE IS COMMUNICATING A LOT OF WHAT GOES ON IN HEALTHCARE, AND HEALTH INSURANCE TO THE AVERAGE CONSUMER, HOW MUCH OF THIS FRANKLY, IS A PRODUCT OF COMMUNICATION AND BREAKING THINGS DOWN SO THE QUOTE AVERAGE CONSUMER CAN GET IT>>STEVE YOU’RE RIGHT ON POINT, I THINK ONE OF THE BIGGEST CHALLENGES THAT WE HAVE IN HEALTHCARE, IT’S A VERY COMPLICATED COMPLEX BUSINESS… BY DESIGN?>>WELL HEALTHCARE IS A LOT DIFFERENT THAN IF YOU WILL MANUFACTURING NUMBER TWO PENCILS IT’S A LOT MORE COMPLICATED IF YOU WILL AND I THINK ONE OF THE CHALLENGES WE HAVE IS THAT WE SPEAK A TOTALLY DIFFERENT LANGUAGE THAN THE AVERAGE CONSUMER, AND I THINK THE CHALLENGE FOR US AND OTHER ORGANIZATIONS IN OUR BUSINESSES WE NEED TO SPEAK A DIFFERENT LANGUAGE, WE NEED TO MAKE IT SIMPLER, LESS COMPLEX FOR MEMBERS AND CONSUMERS TO UNDERSTAND WHEN YOU TALK ABOUT CONCEPTS LIKE PATIENT CENTERED CARE YOU KNOW FOLKS SAY TO ME, ARE YOU TALKING ABOUT NURSING HOMES? NO, WE’RE REALLY NOT TALKING ABOUT NURSING HOMES, SO THERE’S A LOT MORE WORK WE NEED TO DO TO REALLY COMMUNICATE THE MESSAGE SIMPLIFY THE MESSAGE, AND MAKE THE END CONSUMER THE USER OF HEALTHCARE REALLY UNDERSTAND WHAT WE’RE TALKING ABOUT WHEN WE’RE TALK ABOUT TRANSFORMATION OF HEALTHCARE>>I’LL TELL YOU WHAT GO BACK TO HOW YOU STARTED THIS CONVERSATION, THE ECONOMICS, ONE THING EVERYONE UNDERSTANDS IS WHEN YOU CAN’T PAY FOR THINGS YOU SAID THE SYSTEM FEE FOR SERVICE IS NOT ECONOMICALLY SUSTAINABLE, PLEASE HELP US UNDERSTAND THAT AGAIN, WHY IS IT NOT SUSTAINABLE, WHY CAN’T WE JUST KEEP DOING WHAT WE’RE DOING?>>WELL BECAUSE ECONOMICALLY BECAUSE TO BE HONEST WITH YOU WHEN I TALK TO EMPLOYERS I TALK TO SMALL BUSINESS PEOPLE I TALK TO INDIVIDUAL FAMILIES AND CONSUMERS AND THEY FIND OUT WHAT I DO FOR A LIVING THE FIRST THING THEY WILL TELL ME IS THAT WE JUST CAN’T AFFORD THIS IT’S TOO EXPENSIVE, WHAT ARE WE DOING ABOUT CONTROLLING THE COST OF CARE? AND FUNDAMENTALLY WE NEED TO CHANGE THE SYSTEM, THE SYSTEM OF FEE FOR SERVICE IS A SYSTEM THAT GREW OUT OF PERHAPS WORLD WAR TWO WHEN EMPLOYERS FIRST STARTED OFFERING HELTH INSURANCE COVERAGE AND BY DESIGN IF YOU LISTEN TO THE WORDS FEE FOR SERVICE, IT MEANS THE MORE SERVICES I DO THE MORE FEES I COLLECT, IT’S NOT PRODUCING THE VALUE THAT WE NEED TO IN HEALTHCARE,>>EXCUSE ME FOR INTERRUPTING THE MORE TESTS ORDERED THE MORE I GET PAID? DOESN’T WORK…>>DOESN’T WORK, IT’S NOT SUSTAINABLE, YOU KNOW, NEW JERSEY UNFORTUNATELY, IS PROBABLY THE ONE OF THE STATES WITH THE HIGHEST COST OF HEALTH INSURANCE AND CERTAINLY ONE OF THE HIGHEST COSTS OF HEALTH INSURANCE PREMIUMS, SOME OF THIS IS DRIVEN BY THE FACT THAT THE CURRENT SYSTEM OF FRAGMENTED DELIVERY OF CARE, WHICH HAVE THROUGH THE FEE FOR SERVICE SYSTEM SIMPLY ISN’T SUSTAINABLE WHEN WE LOOK AT MEDICAL INFLATION, HERE IN NEW JERSEY MEDICAL INFLATION PROBABLY RUNS SOMEWHERE BETWEEN FIVE TO SIX PERCENT A YEAR, COMPARED THAT TO GENERAL INFLATION THAT RUNS A LITTLE OVER ONE PERCENT SO EVEN THOUGH PEOPLE TALK ABOUT WELL THE RATE OF INFLATION IN HEALTHCARE IS COMING DOWN, IT STILL A BIG NUMBER WHEN YOU COMPARE IT TO THE OVERALL CONSUMER INFLATION. SO WE NEED THE FUNDAMENTALLY CHANGE THE ECONOMICS IN HEALTHCARE WE NEED TO MOVE HEALTHCARE MORE TOWARDS A VALUE BASED SYSTEM WHERE REIMBURSEMENT IS BASED ON THE QUALITY OF CARE, THE OUTCOMES THAT ARE PRODUCED THE PATIENT INVOLVMENT AND THAT LASTLY LOWERING THE TOTAL COST OF CARE.>>THE REACTION YOU’VE GOT AND NOW YOU WERE TALKING TO OUR NEWS ANCHOR MARY ALICE WILLIAMS ABOUT SOME OF THESE ISSUES AND ONE OF THE AREAS THAT YOU STARTED TO GET INTO I WANT TO FOLLOW UP ON IS, THE REACTION YOU GOTTEN FROM THE OTHERS IN THE HEALTHCARE COMMUNITY MORE SPECIFICALLY, NOT JUST, THE PHYSICIANS BUT THE HOSPITALS, ON BOARD?>>CLEARLY THEY ARE, YOU KNOW WE’RE REALLY EXCITED ABOUT THE WORK WE’RE DOING FOR THE LAST THREE OR FOUR YEARS WE’VE BEEN COLLABORATING WITH KEY PHYSICIANS AND HOSPITAL ORGANIZAIOTNS WE NOW IN NEW JERSEY HAVE THE LARGEST NETWORK OF PATIENT CENTERED MEDICAL HOME PHYSICIANS, WE HAVE OVER SIX THOUSAND PHYSICIANS THAT ARE INVOLVED IN PATIENT CENTERED MEDICAL CARE DELIVERY, WE ALSO HAVE A SERIES OF WHAT’S CALLED ACCOUNTABLE CARE ORGANIZATIONS AN EPISODE OF CARE, THESE ARE VERY NEW INNOVATIVE PAYMENT MODELS HAVE HOW WE PAY PHYSICIANS AND HOSPITALS THAT REALLY PUTS THE FOCUS ON THE QUALITY…>>RESULTS?>>AS OPPOSED TO THE VOLUME RESULTS WERE VERY ENCOURAGED BY WHAT WE’RE SEEING FOR EXAMPLE WE DID A STUDY IN 2014 BASED ON 2013 DATA WE TOOK TWO HUNDRED THOUSAND OF OUR CUSTOMERS THAT ARE GETTING CARE THROUGH PATIENT CENTERED MEDICAL HOMES AND WE AN COMPARED THEM TO TWO HUNDRED THOUSAND COMPRABLE PATIENTS WHO WERE NOT GETTING CARE THROUGH PATIENT CENTERED MEDICAL HOME, AND THE INITIAL RESULTS WERE ENCOURAGING FOR EXAMPLE WE SAW FOR THE TWO HUNDRED THOUSAND PEOPLE THAT WERE GETTING CARE THROUGH A PATIENT CENTERED MEDICAL HOME FOURTEEN PERCENT IMPROVE RATE OF DIABETES MANAGEMENT, TWELVE PERCENT IMPROVAL RATE OF CHOLESTERAL MANAGEMENT, EIGHT PERCENT HIGHER BREAST SCREENINGS FOUR PERCENT HIGHER SCREENINGS FOR COLALRECTAL CANCER SO THE INDICATIONS ARE POSITIVE WHEN YOU LOOK AT SOME OF THE COST METRICS ASSOCIATED WITH THIS WE FOUND THAT THOSE TWO HUNDRED THOUSAND MEMBERS AND PATIENT CENTERED MEDICAL HOMES, FOUR PERCENT LESS VISITS TO THE EMERGENCY ROOM, TWO PERCENT LESS ADMISSIONS IN THE HOSPITALS FOUR PERCENT OVERALL LOWER TOTAL COST OF HEALTHCARE FOR THESE TWO HUNDRED THOUSAND MEMBERS COMPARED TO THE TWO HUNDRED THOUSAND THAT ARE NOT IN PATIENT CENTERED MEDICAL HOMES…>>THAT’S OPTIMISTIC…>>VERY OPTIMISTIC, WE’RE ENCOURAGED, WE’RE ENCOURAGED WE’RE COMMITED TO THIS, IT CLEARLY IS A STRATEGY OF OUR COMPANY TO LEAD THE TRANSFORMATION OF HEALTHCARE FROM FEE FOR SERVICE TO FEE FOR VALUE OVER THE NEXT THREE TO FIVE YEARS BOB MARINO IS THE CHAIRMEN AND CHIEF EXECUTIVE OFFICER OF HORIZON BLUE CROSS BLUE SHIELD OF NEW JERSEY AND WILL CONTINUE THIS CONVERSATION AS THIS TRANSFORMATION IN THE HEALTHCARE WORLD CONTINUES THANK YOU BOB FOR JOINGING US WE APPRECIATE IT>>THANKS FOR HAVING ME.>>STAY WITH US, WE’LL BE RIGHT BACK AFTER THIS. [MUSIC] [MUSIC] TO SEE MORE CAUCUS NEW JERSEY WITH STEVE ADUBATO PROGRAMS VISIT US ONLINE AT STEVEADUBATO.ORG, IF YOU WOULD LIKE TO EXPRESS AN OPINION EMAIL US AT [email protected] FIND US ON FACEBOOK AT FACEBOOK.COM/STEVEADUBATOPHD AND FOLLOW US ON TWITTER @STEVEADUBATO>>WE’RE PLEASED TO WELCOME VERONICA RAY, EXECUTIVE DIRECTOR AND CHIEF EXECUTIVE OFFICER OF THE LEAGUERS INCORPORATED IN NEWARK FOR THOSE WHO DO NOT KNOW THE LEAGUERS DESCRIBE IT.>>THE LEAGUERS IS A PRIVATE NON-PROFIT SOCIAL SERVICE AGENCY THAT’S BEEN AROUND FOR ALMOST SIXTY-NINE YEARS NOW, FOUNDED BY MARY B. BURCH THERE’S A UP ON CLINTON AVENUE>>YEAH IN THE SOUTH WARD…>>THE SOUTHWARD OF NEWARK>>OF NEWARK NEW JERSEY AS A YOUNG BOY GROWING UP IN NEWARK AND MY DAD WHO IS HEADING UP A BIG SOCIAL SERVICE AGENCY HE USED TO TAKE ME UP TO THE LEAGUERS CAUSE THEY WERE THE ROLE MODEL OF WHAT A SOCIAL SERVICE ORGANIZATION SHOULD BE RIGHT?>>ABSOLUTELY AND A LOT OF NEWARKERS HAVE COME THROUGH THERE SUCH AS CONGRESSMAN PAYNE WAS A MEMBER…>>THAT’S RIGHT…>>AND HAZEL O’LEARY WAS>>CONGRESSMAN DONALD PAYNE AND HIS BROTHER BILL…>>AND BILL, HAZEL O’LEARY AND A FEW OTHERS…>>BUT THE OTHER PIECE OF IT WITH THE LEAGUERS HAS TO DO WITH HEAD START…>>YES…>>LET’S TALK ABOUT HEAD START, DESCRIBE HEAD START AND WHY IT’S FIFTIETH ANNIVERSARY IS SO SIGNIFICANT>>HEAD START, LUCAS HAS BEEN PROVIDING HEAD START SERVICES FOR FORTY-FIVE YEARS, BUT WHY IS HEAD START FIFTIETH ANNIVERSARY… FIRST OF ALL WHAT IS HEAD START FOR THOSE WHO…>>HEAD START…>>I DON’T REALLY WANT TO ASSUME EVERYONE KNOWS WHAT HEAD START IS, BECAUSE I THINK PEOPLE KNOW AND THEN I GO WHAT EXACTLY IS THAT? NOT EVERYBODY KNOWS>>HEAD START IS A DEVELOPMENTAL AND EDUCATIONAL PROGRAM NOW FOR CHILDREN ZERO TO FIVE IT STARTED OUT THREE TO FOUR YEAR OLDS WAY BACK IN THE DAY, FIFTY YEARS AGO UNDER THE ANTI-POVERTY PROGRAMS…>>WAS IT PART OF LYNDON JOHNSON GREAT SOCIETY>>…JOHNSON GREAT SOCIETY YES, IT WAS AND IT’S LASTED FIFTY YEARS, BUT IT’S LASTED FIFTY YEARS BECAUSE IT WORKS, IT WORKS NOT ONLY FOR THE CHILD IT WORKS FOR THE ENTIRE FAMILY, AND IT WORKS FOR THE COMMUNITY, SO>>DEFINE WORKS, BECAUSE IT’S INTERESTING PEOPLE WILL SAY WELL WHAT DOES IT MEAN TO WORK?>>TO WORK IT MEANS THAT HEAD START IS TOUCHING LIVES IT’S HELPING CHILDREN GROW POSITIVELY, IT’S HELPING FAMILIES TO GROW POSITIVELY IT’S HELPED LEAD A LOT OF FAMILIES OUT OF POVERTY BECAUSE…>>HOW DO YOU LEAD THEM OUT OF POVERTY WITH HEAD START?>>BY HELPING THEM SET GOALS FAMILY GOALS, GOALS FOR THE CHILDREN, AND THEN HELPING THEM ACHIEVE THOSE GOALS HELPING THEM TO UNDERSTAND THAT YOU CANNOT EAT THE WHOLE PIE AT ONE TIME BUT YOU CUT UP THE PIE AND YOU DEVELOP GOALS WHERE YOU TAKE BABY STEPS, AND YOU KEEP MOVING ON AND ON AND ON UNTIL YOU HAVE ACCOMPLISHED YOUR GOALS, I CAN EXPLAIN THAT BY SAYING WE’VE HAD SOME PARENTS WHO CAME TO US WITHOUT A HIGHSCHOOL DIPLOMA WHO NOW HAVE MASTERS DEGREES>>MMMM>>AND WHO NOW ARE WORKING THAT SAME PROGRAM…>>HEAD START A PART OF THAT?>>HEAD START, THEY CAME TO HEAD START AS PARENTS WITH OUT A HIGHSCHOOL DIPLOMA WHO NOW HAVE MASTERS DEGREES AND SERVING ON THE- WHO NOW SIT ON TEH BOARD OF TRUSTEES, SO…>>THAT’S POWERFUL…>>THAT’S POWERFUL, AND THEY NOW HELP RUN THESE PROGRAMS>>YOU KNOW, I GREW UP AS I SAID ON THE OTHER END OF THE CITY IS THIS SOUTH FOR THOSE THAT DON’T KNOW NEWARK IT’S FIVE DIFFERENT WARDS, IT’S AN INTERESTING LITTLE CITY>>YES>>TWENTY-TWO SQUARE MILES THE SOUTHWARD ON ONE END THE NORTHWARD, WHERE I GREW UP, VERY DIFFERENT COMMUNITIES, BUT I ALWAYS REMEMBER WHEN I DROVE THROUGH THE SOUTHWARD THIS VERY STABLE COMMUNITY, RESIDENTIAL COMMUNITY BUT ALWAYS STRUGGLES, RIGHT? ALWAYS CHALLENGES…>>YES>>SO FOR THOSE WHO DON’T UNDERSTAND, THE SOCIOECONOMIC CHALLENGES AND STRUGGLES THAT A CHILD IS, YOU KNOW, FROM BIRTH TO FIVE COULD BE POTENTIALLY DEALING WITH, LIKELY TO BE DEALING WITH, LET’S JUST SAY IN THE COMMUNITIES WE’RE DESCRIBING IN NEWARK, TALK ABOUT THAT.>>TODAY’S CHILDREN, WHERE THE SOUTHWARD USED TO BE SINGLE FAMILY HOMES SINGLE FAMILIES THEY ARE NOW TWO, THREE, FOUR FAMILIES LIVING IN THOSE SINGLE FAMILY HOMES, AND THAT CHILD IS IN THAT ENVIRONMENT THEY MAY BE SHARING THE BED WITH THREE OR FOUR OTHER PEOPLE, THE GANG ISSUE, IS A BIG CONCER TO US IN THE SOUTHWARD…>>VIOLENCE…>>VIOLENCE…>>DRUGS…>>VIOLENCE, DRUGS, IT NEVER ENDS FOR THESE CHILDREN SOME OF THESE CHILDREN FEEL LIKE THEIR MEAL TICKET IS COMING TO OUR CHILD CARE CENTERS MAKING SURE THAT THEY HAVE BREAKFAST, LUNCH, AND A SNACK, AND SOME OF THEM CLOTHES WHEN THEY SHOW UP…>>CLOTHES?>>CLOTHES, SHOES IS AN ISSUE THEN MAKING SURE THEY GET MEDICAL SERVICES, WAS A BIG ISSUE, IT WAS A BIG ISSUE IT’S BETTER NOW, BUT IT WAS A BIG ISSUE… PRENATAL CARE FOR PREGNANT WOMAN, THE LACK OF DOCTORS IN THE CITY OF NEWARK AND IN THE SOUTHWARD, I DON’T HAVE THE STATISTICS FOR THE LAST TWO YEARS BUT BEFORE THAT WE HAD ONE PRACTICE IN PEDIATRITION>>ONE?>>ONE>>IN A COMMUNITY?>>IN THE COMMUNITY>>SERVING ALL THOSE CHILDREN>>SERVING ALL THOSE CHILDREN JUST ONE, SO WE HAD TAKE CHILDREN OUTSIDE THE COMMUNITY FOR MEDICAL SERVICES, SO OUR CHILDREN HAVE A HARD TIME, YOU KNOW, GROWING UP…>>SO WE EXPECT THEM TO QUOTE-UNQUOTE AS WE SAY, YOU KNOW, THEY GROW UP GREAT…>>GROW UP GREAT…>>GROWING UP GREAT IS IT MORE DIFFICULT TO QUOTE- UNQUOTE GROW UP GREAT, FOR THESE CHILDREN THEN IT IS FOR THE REST OF- FOR OTHER CHILDREN WHO GROW UP IN DIFFERENT COMMUNITIES WITH CERTAIN ADVANTAGES?>>I WOULD THINK SO, I THINK IT’S DIFFICULT FOR THESE CHILDREN BECAUSE THEY ARE GIVEN THE SAME ADVANTAGES AND THAT’S WHY WE’RE HERE TO HELP BRIDGE THAT GAP…>>THAT’S WHAT HEAD START DOES FOR THE MOST PART?>>HEAD START DOES HELP BRIDGE THAT GAP TO MAKE SURE THAT THEY ARE GETTING THE PREVENTATIVE SERVICES THAT THEY NEED, THE MEDICAL SERVICES THAT THEY NEED EARLY INTERVENTION, THE MENTAL HEALTH SERVICES THAT NOT ONLY THEY NEED…>>WHY MENTAL HEALTH?>>MENTAL HEALTH, WHY?>>FOR A CHILD?>>FOR A CHILD, THERE’RE CHILDREN WHO NEEDS TO LEARN HOW TO EXPRESS THEIR ANGER, OKAY, BELIEVE IT OR NOT BULLYING STARTS AT A VERY EARLY AGE, AND WE NEED TO HELP CHILDREN REDIRECT THAT ENERGY AND LEARN TO USE WORDS INSTEAD BULLYING OTHER CHILDREN, SO MENTAL HEALTH PLAYS A PART OF WHAT WE DO THE OTHER THING IS SUCH THINGS AS PLAY THERAPY WHERE WE STOPPED TRYING TO LABEL CHILDREN ALL THE TIME AS BEING, ADAO, OR ADD OR WHATEVER IT IS…>>RIGHT…>>AND TRY TO HELP THEM WORK THROUGH ALL THOSE ISSUES, SO MENTAL HEALTH PLAYS A LARGE PART IN WHAT WE DO>>I’LL TALK TO YOU, THE FACT IS THAT AS I THINK ABOUT THIS HEAD START MAY BE TURNING FIFTY AND THE LEAGUERS OF NEWARK SIXTY…>>SIXTY NINE, YES WE’LL BE>>SIXTY NINE…>>YEAH, THE LATE GREAT MARY BURCH STARTED IT AND YOU AND YOU COLLEAGUES ARE AT IT EVERY DAY MAKING A DIFFERENCE IN THE LIVES OF THESE CHILDREN, VERONICA RAY WHO IS CHIEF EXECUTIVE OFFICER OF THE LEAGUERS INCORPORATED IN NEWARK THANK YOU SO MUCH, WE APPRECIATE IT.>>THANK YOU FOR HAVING ME. THE PRECEEDING PROGRAM HAS BEEN A PRODUCTION OF THE CAUCUS EDUCATIONAL CORPORATION CELEBRATING OVER TWENTY-FIVE YEARS OF BROADCAST EXCELLENCE AND THIRTEEN FOR WNET NJTV AND WHYY FUNDING FOR THIS EDITION OF CAUCUS NEW JERSEY HAS BEEN PROVIDED BY THE PNC FOUNDATION WHICH SUPPORTS EARLY CHILDHOOD EDUCATION THROUGH GROW UP GREAT THE NEW JERSEY EDUCATION ASSOCIATION NJIT PSE&G KESSLER FOUNDATION ADLER APHASIA CENTER AND BY NEW JERSEY SHARING NETWORK PROMOTIONAL SUPPORT PROVIDED BY THE RECORD NORTH JERSEY’S TRUSTED SOURCE, AND NORTHJERSEY.COM AND BY NJBIZ, ALL BUSINESS ALL NEW JERSEY TRANSPORTATION PROVIDED BY AIR BROOK LIMOUSINE [MUSIC] [MUSIC] I THINK NJIT THERE ARE A LOT OF SMART STUDENTS I CAME TO NJIT FOR MECHANICAL ENGINEERING BECAUSE WITHIN STATE IT’S PROBABLY ONE THE TOP THREE SCHOOLS FOR ENGINEERING, IT SORT OF CREATES A FRIENDLY COMPETITION WHERE YOU KNOW YOU CAN LEARN FROM THEM IT’S A GREAT ACADEMIC SCHOOL I FEEL I’M BEING CHALLEGNED BUT AT THE SAME TIME I LOVE THE CLASSES I’M TAKING, THE ATMOSPHERE BEING HERE IS LIKE I’M BEING AT AN UPSTART COMPANY IT’S THAT SAME KIND OF DRIVE THAT SAME KIND OF PASSION

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