👶 Some Medicaid reimbursements are shooting higher in New Jersey

👶 It’s part of an effort to improve Garden State birth outcomes

👶 The change is designed to attract more OB-GYNs, midwives and doulas to Medicaid

Pregnant women in New Jersey who are covered by Medicaid usually have to wait hours to be seen by a doctor because the number of providers in the Medicaid system is limited, but that could soon be changing.

As part of an effort to improve birth outcomes in New Jersey, the NJFamilyCare program that covers Medicaid patients has dramatically increased reimbursement rates for perinatal, midwifery and community doula care.

During a visit to Capital Health in Hopewell on Tuesday, First Lady Tammy Murphy said this will more than double the reimbursement for an OB-GYN or midwife from $300 to $861.78 for a natural delivery.

She said this matches 100% of what Medicare reimburses, and makes New Jersey the leader in the nation for reimbursement rates.

dolgachov GettyImages
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Why make the change?

Murphy explained with reimbursement rates for Medicaid patients significantly lower than private insurance “many healthcare providers chose not to see those patients, limiting the pool of available providers.”

She said the result has been long, long waits for pregnant patients, and overworked doctors not having the time to attend to many patients the way they would like.

Layed Down Pregnant Woman And Partner Having 4D Ultrasound Scan
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A better quality of experience for everyone

She said the higher rates will not only attract more providers to see more NJFamilyCare patients “but also will reduce the workload of those who already participate, allowing for a better quality of experience for literally everyone involved.”

Murphy said the message being sent is “regardless of what insurance you have, your life, your health and your baby matter, and we’re going to ensure that you receive the highest quality care.”

New Jersey Human Services Commissioner Sarah Adelman said the shared goal “is making transformational change in New Jersey to support mothers and babies, especially those of color who have been historically and systemically harmed.”

She noted NJFamilyCare covers about 1 in 3 births every year and the new reimbursement rates will result in “greater access to care for the Medicaid members we serve, and greater access is directly tied to improved birth outcomes.”

Newborn baby boy covered in vertix inside incubator
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Adelman said increasing reimbursement rates will also ensure competitiveness “so we can retain and recruit high quality perinatal providers and community doulas to be part of the Medicaid network.”

“These enhancements will lead to positive outcomes for mothers and babies and a healthier New Jersey for everyone.”

The reimbursement increases are retroactively effective as of July 1, and made possible by $15 million appropriated in the most recent state budget, matched by $15 million in federal funding, and federal approvals secured by Human Services for NJ FamilyCare.

David Matthau is a reporter for New Jersey 101.5. You can reach him at david.matthau@townsquaremedia.com

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