NEW JERSEY: Long-awaited primary care pilot poised for approval

Published on Sunday, January 10, 2016

NJEA Secretary-Treasurer Sean M. Spiller spoke in support of the DPCMH model at a Feb. 12 press conference. Source:

NJEA Secretary-Treasurer Sean M. Spiller spoke in support of the DPCMH model at a Feb. 12 press conference. Source:

By New Jersey Education Association

January 10, 2016 – An innovative healthcare proposal that NJEA proposed and has supported for over a year appears poised for approval at Monday’s meeting of the School Employees’ Health Benefits Program (SEHBP) board meeting. After months of delays, the SEHBP board is expected to join the State Employees’ Health Benefits (SHBP) board in offering members the opportunity to join a pilot program to test the use of Direct Primary Care Medical Homes (DPCMH) to improve health care outcomes for members while also lowering costs.

UPDATE: (Jan. 11, 2016)
Plan Design Committee approves new option for SEHBP
Voluntary pilot program to improve care, control costs …

Published on Monday, January 11, 2016

If successful, Monday’s vote would represent a significant victory for NJEA in the fight to preserve and enhance members’ health benefits while controlling premium costs. Last February, NJEA Secretary-Treasurer Sean M. Spiller advocated for the DPCMH model at a Statehouse press conference.  Spiller said then, “For too long, negotiations over healthcare boiled down to who would pay what.  Would employers pay higher premiums every year, or would employees pay more, even as the level of coverage often decreased?  For every winner in that system there was a loser.  And sometimes, everyone lost.”  He added, “I’m very pleased that we are moving forward on a third option that promises to control costs for employees and employers while improving the quality of healthcare that our members will receive. If we make this work, everyone wins.”

DPC Consumer Guide cover_2015_KINDLENJEA President Wendell Steinhauer also praised the plan last year, noting, “For once, we are talking about how to make health care better and more efficient, rather than just how to shift costs to employees. This is a market-based, win-win proposal that benefits everyone.”

The pilot, which would be completely voluntary, would represent an added benefit to members at no additional cost. NJEA believes that by improving the quality of care while slowing the growth of health care costs, the pilot will benefit members.



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