“In February the school board approved entering a partnership with Integrity Health LLC. and March & McLennan to create a “partnership health care center” located in the CASD boundaries.According to a Integrity Health’s website, the New Jersey-based health care organization entered into a similar agreement with Tom River School District. The center in Coatesville would be the second facility opened by the company, a news release posted on Integrity Health’s website says.The deal with Toms River was estimated to save the school district “$1.98 million, providing the equivalent of $4.98 million in primary-care service through a $3 million annual contract,” the news release says.In August, Integrity Health President Douglas R. Forrester told the publication NJ Spotlight that the company was in the process of building its second Partnership Health Center in Coatesville.”FROM:
Daily Local News 11/13/2013
Well and good is a new thing in Toms River:
"TOMS RIVER — Michael Ritacco, the once- powerful superintendent of the fourth-largest school district in New Jersey, will spend most of the next decade in a prison cell.
Calling it the worst case of public corruption he’s seen, U.S. District Court Judge Joel A. Pisano today sentenced Ritacco to 11 years and three months in federal prison and fined him $100,000 for bilking Toms River schools, setting up inflated insurance contracts and extorting up to $2 million from the brokers as kickbacks."
... "I’m glad it’s over," said Alex Pavliv, a member of the Toms River school board who won election last year on an anti-Ritacco slate. "I think there clearly was a lack of oversight and hopefully this era is (behind) us and we can set about rebuilding this district for the children and taxpayers of the township instead of the crooks."
In a statement, Toms River Board of Education President Ed Gearity called the sentence the "conclusion of a sad chapter in the history of our district and our community" and said the board changed its policy on insurance in response to the case.
"It is most unfortunate that our reputation is being damaged by the actions of a few individuals who schemed to defraud our district," Gearity said. "Our community takes great pride in our schools and will continue to take great pride in our schools.”
MORE AT:
Former Toms River superintendent is sentenced to 11 years forbribery, tax evasion
Matt Friedman/The Star-Ledger By Matt Friedman/The Star-Ledger
on September 14, 2012 at 8:20 PM, updated September 15, 2012 at 2:11 PM
"This kind of model of a face-to-face, home base that is totally integrated for medical care is the only way to produce better health outcomes"
TOMS RIVER — A generation ago, 54 Washington St. was a grocery store and an anchor for the business district in downtown Toms River. Today, the nondescript brick-and-glass building is the health care hub for nearly all of the 2,200 employees of the Ocean County School District and their families.
And if one entrepreneur is right, it will be a model for how thousands of New Jerseyans will see their doctor — and how employers will manage insurance costs — when President Obama’s health care program takes effect next year.
At the Partnership Health Center, members can pick up prescriptions, get their backs adjusted or have their child’s injured arm X-rayed and set almost as easily as residents picked up lunch meat or a quart of milk at the same spot more than 30 years ago. Same-day appointments are the norm, and the only reason to carry a wallet is to flash an identification card.
If the building seems familiar to residents of the shore community, so might the name of the man whose company operates the center — Douglas Forrester, who ran for the U.S. Senate as a Republican in 2002 and for governor in 2005.
"This kind of model of a face-to-face home base that is totally integrated for medical care is the only way to produce better health outcomes," said Forrester, the president of Integrity Health, which runs the center. "And if you don’t produce better health outcomes, you are not going to save money."
MORE AT:
Toms River 'medical home' may be future of N.J. health care
Susan K. Livio/The Star-Ledger By Susan K. Livio/The Star-Ledger
on January 07, 2013 at 7:00 AM, updated January 07, 2013 at 4:42 PM
Because of "The Affordable Care Act" medical care is has already begun to change. Maybe the Coatesville school administrators are right and a health care clinic that's on the CASD campus is a good way to go. Let's hope so.
"Companies that self-insure health plans hope to improve care while lowering costs.
When the Toms River Regional Schools’ 5,700 employees and families get sick, they usually go to the Partnership Health Center, a clinic in downtown Toms River that opened two years ago for the exclusive use of members of the school health plan. The PHC is voluntary; members are free to use any of the hundreds of doctors in their health plan network. But there’s an incentive to use the PHC, since there are no co-pays or deductibles, and it’s convenient: the PHC is open seven days a week and, members can visit during working hours, then return to their jobs. The 18-person staff includes three doctors and six nurses, and services include physical therapy, x-ray, lab, and pharmacy. Emergencies like wound care, splints and stitches can be handled at the PHC, instead of a hospital emergency room.
There is a fitness center with exercise machines where physical therapy sessions are held, and members get advice on how exercise can ease their aches and pains. Members with chronic conditions like diabetes and heart diseases can get help with weight loss, nutrition and fitness."
MORE AT:
NEW JERSEY SPOTLIGHT
HEALTHCARE
EMPLOYERS START TO TAKE AN ACTIVE ROLE IN EMPLOYEE HEALTHCARE
BETH FITZGERALD | NOVEMBER 17, 2011
MORE ON HOW THE AFFORDABLE CARE ACT MAKES EMPLOYER FUNDED HEALTH CARE AN OPTION FOR EMPLOYERS:
"And even better news, we are seeing an increased interest in self-funded plans in the marketplace. According to a study of 326 health industry executives by Munich Health North America, published earlier this year, 82 percent said they had seen a growing level of interest among employers in self-funding their group health insurance plans over the past 12 months, with one-third expressing a “significant” interest in self-funding. In the same study, 70 percent of health organizations were expecting to grow their self-funding portfolios in the coming year. Overall, the interest in self-funding is increasing as a direct result of the ACA.
Additionally, for employers choosing to play by the rules established for the employer mandate, employers now have an obligation to offer all of their full-time equivalent employees the opportunity to enroll in coverage. Meaning, health plans that were once only available to management or salaried employees now must be offered to the balance of the workforce, thereby scaling up the employers count of employees, turning small groups into large groups, and these large groups into excellent candidates for self-funded plans.
Although self-funded employers will be subject to many of the same requirements of the ACA as their fully-insured counterparts, such as lifting restrictions on lifetime and annual limits, waiting periods, pre-existing condition limitations, and expanding dependent coverage for children up to the age of 26, self-funded employers are uniquely positioned to save money on plan design and cost containment. For example, narrow-network plan designs offer self-funded employers the ability to share health costs with the provider community, allowing for deeper discounts. Although the plan design itself is a less robust option than a traditional PPO or EPO network, and subsequently less expensive, it still meets the requirements of the ACA and provides comprehensive benefits to employees. The self-funded employer also has the say on which providers they contract with, creating a network that is personally tailored for the employer’s population, providing exclusivity and cost control that is unavailable in the fully-insured market."
MORE AT:
Pinnacle Claims Management
HOW THE AFFORDABLE CARE ACT IS CREATING OPPORTUNITIES FOR YOU AND YOUR SELF-FUNDED CLIENTS
11.06.2013
By PCMI Staff
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