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new jersey monthly the magazine of the garden state available at newsstands [music playing] [music playing] welcome i'm steve adubato everything you ever wanted or needed to know about the world of healthcare we have joe berardo who is the chief executive officer of magnacare which is? >>it's a health plan services company statewide in new jersey and new york >>joe last time you were with us it was before the implementation of the affordable care act right? >>that's right that's right >>alright so we're doing this in the fall late fall of 2014 your assessment of otherwise >>[laughter] known as obamacare what why are you laughing? how are we doing? >>you know what? i think there's a lot of good there's been a lot of good but there's been a lot of questions and challenges and i think... i've never seen healthcare in this

state before. it's very very disruptive and you know massive changes. >>okay so one of the things you have talked about and we need to talk about is something called high performance networks otherwise known as narrow networks. by the way why all the jargon? [laughter] >>well listen narrow sounds negative so you know i think what's... >>high performance sounds good >>high performance is good and it... >>what is it? >>well high performance is really where we need to get to go where we need to take this whole thing is clinical and integration. so when you think about health plans of the past you know we've kinda gone through this morphing of idemnity plans years ago when i started in the business 25 years ago you saw hmo's show up and then consumers didn't really like it >>health maintenance organizations >>health maintenance organizations kinda narrow networks and they were viewed to be strict. and consumers kind of pushed back on that especially during an expanding economy nobody really needed to save money benefits were really important for employment as far as recruiting and retaining talent we've gone full circle now

to where we move data kind of a tightly managed programs went to broad ppo networks >>preferred...? ...provider organizations >>okay. yeah see... >>the jargon in my business is is a lot of fun right sorry about that >>yeah right >>um and now what's happening i think in order to get ourselves kind of under control and do the things that they think will really be meaningful is we have to have the physicians and hospitals and ancillary providers you know truly clinically integrated with the patient in the center >>what does that mean? truly clinically integrated what does that actually mean? >>we have to share the data you know when it... >>give me a for instance >>so right now we have all this wonderful data all this clinical information that comes in on claims medical claims pharmacy claims you go to the pharmacy you go to the lab there's lab values this kind of paints a picture of what's going on with you clinically you also have populations like employers now that you understand what's driving the risk and the cost inside of an employer. what doesn't happen is in many cases is the

provider doesn't get a big or full picture of that so you show up at your doctor and really all he knows is what he's done historically to you or what you tell him has been done to you or for you >>hmm >>and he tries to integrate that so i think what we're seeing now is a real push on having systems that can talk to each other having information that can be pushed back to the provider community so they can get a full picture of a member of a patient and really help them manage their disease state whether it's a chronic illness or just an acute episode but really the... we gotta get the information into the provider's hands >>where's the pushback joe? >>you know i don't think it's pushback. >>you don't? >>no you know i think everybody... >>you don't sense medical community pushback okay this is complicated? too hard for us you don't see it? >>uh no i think everybody's excited to do it. >>okay >>it's expensive you know the issue you have to... >>what's the payoff? >>well you know the payoff over time is gonna be in some ways it's gonna be survival because you know the

reimbursement model is changing so if you look at what really is happening inside health reform we have exchanges we have subsidies we have all this stuff >>you mean the healthcare exchange? >>the healthcare exchange >>but you go on this... these websites and you pick... >>right so you can pick a plan and the government's subsidizing for some people and you have expansion of medicaid in some markets but what's really going on in health reform is you have medicare and medicaid changing the way they pay physicians and hospitals for different types of disease states. not paying for certain things like readmissions or paying less for observation benefits this is all driving a change in how healthcare is gonna be paid for so rather than a physician getting paid more to do more what's going to occur is they're gonna get paid for kind of value so in other words we see some big hospital systems coming together here in this state >>sure >>um you know that makes some people nervous i think it has to happen over a period of time because ultimately what needs

to occur is we need to put the dollar in the control of the provider. the provider needs to manage the patient and provide access and services and if they do it efficiently they get rewarded. they get to keep more of that dollar >>how does the patient benefit? >>the patient benefits cause they're gonna be at the center you know i think right now it's... you know a patient is really left in many cases other than going on the internet and researching what they might have is you know my knee hurts i'm going to the orthopedist i got a chest pain i'm going to the cardiologist you know there's really... there's no continuity unless you have a very active... >>it's fragmented? >>it's very fragmented. and it's wasteful. you know every one of those providers might want their own mri or their own lab results or you know they're not talking to each other >>that's what you meant by integrated? coordination? >>integration. we gotta get it coordinated. it's a journey by the way this isn't happening next year... this is a five ten year journey into ancillary treatment... >>so hold on one second joe when people say oh we gotta fix the healthcare system do you laugh when people want to say that? [laughter] >>yeah it's way way more complicated than... >>fix that thing... [laughter] >i'd love to fix it but it's you

know it's... >>but there is no "fix"? >>there really isn't. you know i was at a conference yesterday with a bunch of oncologists and one of them had said something pretty profound was you know some of the work that's getting done here in the next five years or so is really to leave the place better than it was before you know some of the physicians and hospital executives and insurance guys may not be around for the full implementation of this but you know we're gonna get to a model where the provider and the patient relationship is way more at the center than it's been historically >>what about for businesses? what does it mean for most businesses who have to or are providing health insurance for their employees where's the benefit for them? >>you know in the near term you know there's still costs because as doctors get bought by hospitals and acquisitions occur you know they have to get financed so that shows up in the rates whether it's a provider rate or an insurance company rate so in the near term i think we're gonna still see some cost trends as this organizes >>cost trend. what does it mean

in insurance? >>you know i mean your insurance is gonna go up you know still gonna go up the next couple of years or something >>and if someone says i blame that on the affordable care act is that too simplistic an analysis? >>you know it is. i think right now it is. you know the affordable care act in many ways is i think just a messy law i think we could have gone at it a little bit differently >>sure >>and i mentioned that last time we spoke >>but you don't blame everything on that? >>i do not. and in fact you know the good part of the affordable care act is it's forcing payers and providers and employers and other stakeholders to be in a room to figure out how does this all come together. you have providers becoming insurers you have insurers buying providers and you know and in he end i think this is gonna end up being where the consumer gets what they need but from a much more integrated system >>finally >>finally? >>you're optimistic? >i have to be [laughter] exactly >>[laughter] cause the alternative is not >>yeah you know i think the alternative you know people talk about a single payer system and you know that's not the panacea i've gotten to

attend conferences you know capital conferences private equity type things and you know the guys that are doing this on a national basis whether it's canada or england or egypt i got to meet the minister of health in egypt, they're figuring out how to privatise it because they can afford to pay for it >>wait a minute everyone who talks about the single payer system you're talking about those countries hey why don't we be like them? they're looking at... [laughter] >>yeah they're looking at how do i get out of the business so it's... you know... it's interesting. so... >>no one way >>there's not one way and it's not easy and you know i think people need to be open minded and you're gonna end up having partners that you never would have thought you had in the future >>well we appreciate you being a partner with us to try to break this down and make sense everytime you join us joe you help us understand more joe berardo is the chief executive officer of magnacare thank you joe we appreciate it thanks for having me steve appreciate it >>stay right there we will be back right after this >>to see more caucus new jersey with steve adubato programs visit us online at www.steveadubato.org if you would like to express an

opinion email us at info@caucusnj.org find us on facebook at facebook.com/steveadubatophd and follow us on twitter at @steveadubato >>we are pleased to welcome doctor sue henderson president of new jersey city university. good to see you. >>thank you. good to be here. >>first time with us so you have great things going on in your campus? >>yes we do. it's an exciting place to be right now. >>let's name some of them >well first of all i'm living in a city that's on the rise >>jersey city? >>jersey city. mayor said last week that there will be 50,000 more people moving into this city in the next three or four years. we are... >>we've had steve fulop many times. he says that you're gonna have also the largest population in the state soon? >>we are. we are. we are on the grow and we are the public institution in our city. so we want to make sure that we're doing what they need and meeting the needs of our community. >>how do you keep your tuition as low as it appears to be? >>so we have the lowest tuition

in the state and we do that we think by being efficient we have been very careful about how we spend our money we have students who come to us who are... lot of them are needy and so we need to make sure that they can get through in a timely manner and that they haven't left with a lot of debt as a matter of fact our students we leave with the lowest debt in the state. >>the lowest? >>yes. yes, below the national average. >>how? >>um because we have a lot of aid that we provide for them we have fundraising that we have done with our foundation that provides and then the institution works out ways to help them get through >>the other thing that strikes me is that it has been said and i'm sure you'll back it up the safest campus? >>yup. um... >>now you're in jersey city >>we're in jersey city >>you're in an urban area >>mm hmm >>talk about safe campus >so our campus is... it's fenced in and we have very good security but our clery act which every institution in the country has to do reports

and our data's lowest of anybody in the state and we think that's because we take care of our students we're very careful about when they leave campus and how they leave campus >>doctor who are your students? >>so our students are very diverse. we are what i would call a majority-minority campus >>wait a majority-minority campus? >>minority >>go ahead >>so that means more than 50 percent of the students who attend njcu are an ethnic minority of some sort so we have 35 percent hispanics about 21 percent african americans... we have asians indians and pakistanis egyptians lish italians and irish a little bit of everything >>you know i've noticed you have a very aggressive i call it branding because i write about branding i think about it a lot and so it struck me as... it struck me that you have an aggressive branding campaign >>so one of the reasons we're doing that is we think that people don't know who we are nor what a good value we are

for students and for our community. so we're trying to sell that story in a lot of different ways. >>but the brand. how would you describe it? >>better known than it used to be. and strong. getting stronger. getting stronger. again we're trying to get our news out and talk about the good things that are happening on campus. we... for example we have a remarkable security studies doctorate program actually it's the only one of its kind in the country our faculty in that particular department have finished their work either at the cia or at the army or in the military or in the police and they are training the future leaders in that field >>the other program that you have that a lot of people talk about is the music business? when people said music business i said wait a minute is it a business program? is it a music program? i said no it's business and music together talk about that >>that's exactly what it is we've had for a long time a very strong music dance and theater program. so students come to us for the aspiration of wanting to perform on

broadway but not everybody's gonna end up being a performer so we have a track within the music dance and theater program that is music business. cause... >>talk about what does that really mean... i don't... they should have a course called public television business [laughter] >>[laughter] >>being the business... no seriously i mean i love the art of public television is the fun part interviewing people producing great packages we have wonderful people on the artistic side >>mm hmm >>but i mean the business of public broadcasting is running a tight operation raising money the business >>that's it >>is that what you're talking about? >>that's exactly what it is so anybody who's gonna be in the music business program needs to know and understand how you do recording how you promote your artists what a good artist looks like and what the market's needing. >>just like there's a business of higher education. by the way describe the business of higher education >>oh that's a good one well i'll talk about a program we're looking to put together and that is about the business of higher education. i would say that higher education today is about the business of creating knowledge educating the future and becoming

an economic driver for each region and for this country >>go the last part. you have an initiative... talk about an economic driver... a $42 million construction project on 22 acres of land in jersey city >>that's correct. we are going to be doing four different buildings over the next four or five years. we have a science building that we are doing on our campus that is a $42 million project that is part... funded in part by the state and part with our own money and that will help our faculty who are scientists and our students to do research that will be useful but also then prepares to go out and work in the pharmaceutical fields and go into medical school. on our 22 acre campus which we've been spending about eight years remediating we will be putting out an academic building which will be for our music dance and theater program as well as a dormitory for another 450 students so... >>so back up for a second you know we've talked to steve fulop several times

on our sister program new jersey capitol report >>mm hmm >>and when we do you know he talks a lot about the economic engine in jersey city... you see yourself you see the institution as a big part of that. >i do. in two ways. in two ways. the west side of the city is a part that hasn't seen as much development as the side that's closer to manhattan. we are putting our school business on the east side which is closer to manhattan. as a matter of fact you'll be sitting in your finance class and your mba program and you'll see the world trade center. which will be fascinating. absolutely fascinating. but the other side of the city the west side has not been developed until we are actually working with local developers as well as with the mayor's office to find market rate housing to put up on some of our property as well as things like a grocery store, a fitness center, all these things we think will help... may bring the life to this side of the city an economic driver... but also

provide services for our students >>all part of the university? >>yes. >>new jersey city university is changing all the time because their needs change the opportunities change and part of a great city currently the second largest city in the state and the mayor steve fulop believes it will be the first... we'll see >>we'll see >>doctor sue henderson president of new jersey city university i want to thank you for joining us it won't be the last time >>thank you. it was fun. >>good having you >>stay with us. we'll be right back right after this >>to see more caucus new jersey with steve adubato programs visit us online at www.steveadubato.org if you would like to express an opinion email us at info@caucusnj.org find us on facebook at facebook.com/steveadubatophd and follow us on twitter at @steveadubato >>doctor shuvendu sen

is associate program director internal medicine residency raritan bay medical center and tom allen back with us again ceo and president summit behavior health good to see you >>thanks good to see you >>yup >>as we speak a package of bills introduced in the state legislature dealing with a crisis... a crisis dealing with opiate addiction... dealing with prescription drugs and a whole range of ills trying to deal with this crisis. talk about part of this tom that deals with prescr... physicians as the gatekeepers to those who are trying to get access to these drugs that they really shouldn't be getting access to >>uh my experience has been some had recently opened a 40 bed detox in union new jersey >>tell everyone what your organization does >>um summit behavioral health is a drug and alcohol treatment provider in new jersey we recently opened a 40 bed detox we have a number of outpatient centers at the detox we deal with a lot of

prescription drug overdoses and abuse and what we're seeing a lot of is that the physician becomes this may be trite but in a lot of ways the physician becomes the drug dealer, they're the gatekeeper for this particular class of drugs we had a client not that long ago who came in no prior history of drug and alcohol abuse, wasn't aware after a knee operation that he was gonna have any untowards effects after taking this edication... tried to get off of a pain pill in three months realized he couldn't get off and he needed to come in for detox purposes i believe that it's the physician's repsonsibility as the gatekeeper for care that they should inform these clients exactly the cause and effect at any potential complications >>so the legislation that we're talking about while there are 21 bills there's one bill that says what? >>it says that you know physicians they need to inform the patients that yes i'm giving

a controlled substance and if i'm giving these are the adverse effects and... >>that's not required right now? >>well now we got to tell the patients and then we got to document that i have informed the patients. it was all about suggestions and guidances that we gave them... now it becomes like a documentation that we are telling the patients as of now that these are the adverse effects and this could be the other alternative methods of treatment other than giving this controlled substance >>well we have to tell the alternatives as well >>right >>yes that they're... that alternative treatments... they do exist >>what kind of reaction do you think you get from your colleagues? >well you know i think that it's a general awareness now we realize that this is a man made epidemic. it's quite a paradox. because the very same people men and women who are in the business of saving lives we are the point of entry >>that's right >>so we now realize we do realize i mean this is something that was not born overnight it was there for the last many number of years but we realized that this is a situation which has become an epidemic. and it's a nexus. we know that by giving these

prescriptions it's not just restricted to the prescription it introduces addiction so the person concerned goes for the other sources of euphoria so it is now our responsibility to make sure that being from the patients that these are the long standing adverse effects >>hmm >>and these are the alternative treamtents that are involved >>and there has... >>tom >>there has been... we want to x now... we want to... i come in to see my doctor and i hurt my shoulder playing pick up basketball... i want the quick fix i want a pill that will make me feel better now we're the get better now society i think you're seeing a lot of exposure to drugs at a younger age the gateway drug is no longer marijuana kids are learning about drug use whether prescription or ilicit drugs online social media and they're learning how to do it, what it feels like so there's not that same fear or concern tied to it i think it really... we go into our doctor's office and we

nt a quick fix it takes a little bit more effort on the physician's part to be able to push back with a client and say look these are the alternative courses and it may take a little bit longer but it's safer and i think honestly another piece is the managed care idea that we're in a society where managed care dictates a lot of and i don't want to say the course of treatment but heavy volume primary care practice a doctor's on the hook to see 12 10 12 15 clients every couple hours and now we're putting a couple more requirements into each visit every time they prescribe a medication so there may be some pushback on that end. one of the pushback... >>but it's necessary? >>it is necessary one of the things i'm hearing is that real concern from the medical community isn't some of these issues it's the additional paperwork requirement >>paperwork? >>clerical >>and what's the response to that doctor? >>well.. >>you're talking to your colleagues right now and they

one of your colleagues said you know i want to be helpful i know there's an epidemic prescription drugs the opiate addiction we talked about but there's a lot of paperwork you say what to your colleagues? >>yeah because this is a change of mindset that we need i mean i... when i discuss with my colleagues and that's the type of discussions we have where we say yes there's a lot of paperwork okay there's going to be some amount of time that we have to dedicate to this >>but what? >>about you know... >>but? >>but the problem is... well the change of mindset is this to be on the positive side the gist is for any other disease let's sat stroke we have a dedicated team we have nurses you know we have dedicated social workers for congestive heart failure we have a dedicated team. what we need here is a dedicated team so it cannot it's difficult for the physicians to do all of these at the same time but if there is a dedicated team which looks into this you know prescription drug abuse i'm sure it will be done as a team as a unit >and there were 21 bills in this

package >>yes >>right >>and no one you know it's not all on doctors it's on parents. it's on... who else is this on? i mean you understand this from a provider perspective including personal >>it's the community >>so go ahead >>i believe it's in incumbent on each and every one of us six in ten new jerseyans know somebody whether it's a family member coworker friend neighbor that's impacted by addiction i think for too long addiction has been viewed primarily as a criminal justice issue not a public health issue and it really is a public health issue. and that mindset is hifting slowly but it's shifting we're seeng you know the war on drugs was an admitted failure by you know by the government so i think we're seeing this shift in philosophy it's taking time i believe it's incumbent on each and every one of us in the community you know one of the things i've noticed recently >>a few seconds go ahead >>yeah one of the things i noticed recently is that there's been more outreach september is national addiction awareness month but there's been more

recovery walks focus on recovery focus on the positives and not the negative that people can and will recover that treatment does work but it's gonna take time it's gonna take a concerted effort by all of us >>you're confident we're moving in the right direction? >>i'm very happy with the awareness that's coming i'm a strong believer in the fact that any education specifically for medical education it needs governance it needs discipline it needs accountability and i think this is a good move >>we cannot do this without physicians >>absolutely >>and we cannot do it without all of us together i want to thank both of you for joining us in this fight... the fight continues and we'll continue to do our part in public broadcasting thank you very much >>thank you >>thank you very much >>the preceding program has been a production of the caucus educational corporation celebrating over 25 years of broadcast excellence and thirteen for wnet njtv and whyy funding for this edition of caucus new jersey has been provided by robert wood johnson university hospital

actavis in cooperation with the american medicine chest challenge steve and elaine pozycki new jersey manufacturers the russell berrie foundation choose new jersey and by the fidelco group transportation provided by air brook limousine serving the metropolitan new york new jersey area caucus new jersey has been produced in partnership with tristar studios hi i'm eric. you might see me as an ordinary person but i've been living with a brain injury for nearly two years. one of my struggles is short term memory loss. at opportunity project i'm given hope and support and i've gained my confidence back through the job placement program despite my challenges i have reason to keep improving today even though life has changed me i believe that anything is possible if you have a brain injury you don't have to face your road to recovery alone closed captioning provided by aciem studioss

captioning sponsored by macneil/lehrer productions >> ifill: simmering anger and unanswered questions in the wake of a missouri grand jury's decision not to indict police officer darren wilson for the death of ferguson teenager michael brown. good evening, i'm gwen ifill. >> woodruff: and i'm judy woodruff. also ahead this tuesday... as communities across the nation absorb the missouri decision, what happens next? >> ifill: then, in an effort to fight obesity, the f.d.a. announces unexpectedly sweeping new rules that could change what and how much we eat. >> woodruff: plus, scientists aim their telescopes' toward the skies for a glimpse of a previously unseeable thing. >> so the first question is do black holes exist.