>> a dangerous drug makes a comeback in hackensack, but this time, with a dangerous twist. >> and you will see that they are very close to their moms and that is why i call them mama's boys. >> my mom is afraid that she will bury me. >> i am not afraid because of it, but lack of toughness. >> i am addicted to every drug i put in my body. >> and they have developed a method of communicating unlike any we have seen before. >> and asap, please give me money a sap. >> we are on the same wavelength and i don't know who picked up on that kind of thing, but they did. >> and we once again give them cameras to record their intimate thoughts. >> and if he were to kill somebody, i would be right next to him hiding the body. >>> the 40,000 or so residents >>> the 40,000 or so residents of quiet hackensack, new jersey, can visit the glitz and glamour of new york in less than an hour, but in the outskirts of hackensack is a place where compelling drama plays out everyday. there are about 900 men and women incarcerated inside of the bergen county jail. most are only accused of crimes and awaiting tr

while some consider it a suburb of new york city, hackensack has its own character and faces its ownllenges. you can find examples just outside downtown, at the bergen county jail. >> he's cleared. >> while some of the men and women incarcerated here have been convicted, most are only charged with crimes and are awaiting trial and the resolution of their cases. >> this is like country club compared to my county jail. >> william bernard might disagree with the country club description, except for a brief stay driving with a suspended license, this is his first extended stay in jail. bernard says his four months here have caused him panic attacks and worsened his stuttering. >> i would stutter sometimes when the anxiety level would get real high on the outside but nothing like on a -- on a daily basis to where guys on the unit would be making fun of me because that's just, you know, the way i'm talking every day. i guess some people look at you and don't like you for some reason. they just target in on you and a lot of them have been in there for ten months, 12 months, so they're alrea

finally mori macker, the president of hackensack alliance. morey has been a member of forest health care associates since its inception in 1997 and he's worked there on implementing a comprehensive multidisciplinary approach to help patients become partners that their own care and wellness and is engaged on the ground with trying to implement these reforms. so i'm going ask our panelists to make some opening or framing comments then we'll have a back-and-forth discussion. jennifer, i'd like to start with you, please. >> sure, thanks for having me. i enjoyed this morning's presentations. so i work for the national partnership for women and families. we're here in washington. we are a consumer organization and we've been around for more than 40 years working on health care issues including system delivery reform. as a consumer organization we have historically been supportive of new delivery models that have the potential to lower costs, to improve outcomes and to improve patient experience so from the beginning we look at acos as a potential b

a practicing internist for about 30 years and also the zrebl director of population health for hackensack university health network. 234 that role i initiated and was assisted by the hospital in developing our aco. we were in the first group in 2012 for the mssp program. we looked at it a little bit differently. our philosophy was we were going to use this as a clinical laboratory. we were jumping in to the value-based reimbursement scheme and so we decided to limit to primary care physicians to mandate patient-centered medical homes for all of our primary care offices that we bore the cost of all of the training for the primary care -- for the patient-centered medical homes. we mandated electronic medical records and we purchased a relative relatively strong population health electronic health system which emrs fed data into. this was all up front monies that the hospital, surprisingly enough, was willing to invest in this organization. we started with a little over 12,000 mssp patients with a little over 50 physicians and i'm happy to say we saved in excess of $10 million on those 12,00

the most glaring example of neglect and inaction may be this sad ittle railroad bridge over the hackensackw jersey. it was built 104 years ago and is, according to amtrak president and c.e.o. joe boardman, critical to the u.s. economy. >> joe boardman: this is the achilles heel that we have on the northeast corridor. >> kroft: how much traffic goes over it every day? >> boardman: it's almost 500 trains a day. it's the busiest bridge in the western hemisphere for train traffic, period. >> kroft: and what kind of shape is it in? >> boardman: it's safe, steve, but it's not reliable. and it's getting less reliable. it's old. its systems are breaking down. there's an inability to make it work on... on a regular, reliable basis. >> kroft: boardman says the portal bridge is based on a design from the 1840s, and was already obsolete shortly after it was completed in 1910. it's a swing bridge that needs to be opened several times a week so barges can pass up and down the river. it takes about a half an hour. the problem is it fails to lock back into place on a regular basis. and what kind of proble

. >> the hackensack. >> and it looks like that continuing into the fourth quarter. it looks like fourth order earnings could go below estimates. you do not know what discounts could be going on. the numbers look good. in particular canada looks relatively strong. they have been struggling with the canadian business, but they should be up in the mid to high single digits in the fourth order. it does seem to have taken hold to some degree, but we all know one quarter does not a trend make. we have to see target deliver on these fourth quarter promises. >> i think target could be .elivering because they are expanding. let's expand the conversation. gary v. is still here. rachael is the founder of a company that has a partnership with target. the target lady to be kristin weight behind the register with a slight -- krist in wiig behind the register with a slight afro. actually that is more like my haircut. >> we have been in sharply. targetalways been a customer. they have something for everyone whether you are a teenager, a homemaker, a schoolteacher. it is an opportun

you have limited time and resources and more hackensack fronted the funds to tryout these reforms and expand what works. it suggests that this is going to take time. there going to be failures and bumps along the way. are there steps through better evidence sharing or other policy steps that could accelerate that and make the work you are doing or trying to do go more quickly? maybe happen at a faster pace? >> you hit the nail on the head. that is we started with a snul group of a clinical laboratory. the question is where is the benefit to jump into the pool rather than just sticking your toe into the pool? the hospital organization, very large physician organizations are dependent on the service dollar right now to pay their bills right now. there needs to be enough of a carrot at the end of the road to make organizations willing to sort of hit that tipping point and say we are going to jump in on value based. there certain sticks that cms is using such as the decreasing reimbursement or the penalty on the hospitals. the carrot is not there. i think we had discussions on the shared

. >> hi, morey menacker from hackensack. i heard sean discuss very, very briefly information, and his comment was that monthly they were supplying claims data to the acos. but we all know that the claims data from cms can be up to 12 months delayed. so even if you're getting it monthly, you can't accurately predict what's happening with your population and make changes. now, we've had some brief discussions about health information exchanges, and data sharing. but it seems clear to me that the successful organizations, be they acos or not, are able to share data, clinical data, and be able to make appropriate decisions based upon that information. but yet, the government, with all its regulations has absolutely no regulatory oversight over electronic medical records and transfer of information. and has sort of left that to the private sector. the question is, is there a mechanism that we can utilize to improve data sharing to be able to really change our ability to quantify best practices and minimize wasteful spending. >> y

old built in the 1930s on how the trains run, porthole bridge which is a swing bridge over the hackensack that was designed way back in the early part of this century. in fact, the design itself goes into a century ago. and built in 1910. $100 million is lost if we shut down this corridor for just one day according to a study done by the northeast corridor commission. >> joe, you guys have been in a battle with southern and csx over delays. it feels like a delay for the passenger, but you often say it's not our fault, it's these other guys. it's their track and they screw it up. how easy is it for them to fix that problem? >> it's not an easy problem to fix right now. just look at the number of cars of oil that are traveling now compared to 2009 or 2008 where there were less than 10,000 units. now we're talking maybe 600,000. so you really have -- chicago is set up as an interchange location between eastern and western railroads. it takes a long time to get through chicago. the railroads are making major investments in their infrastructure. and they're trying to fix the problem. there's n