The problem:

Following the Affordable Care Act (ACA) and New Jerseys Medicaid expansion package, data
has shown that specific regions in the state are exhausting the financial allowances. Medicaid
beneficiaries in low-income, urban areas are not receiving quality healthcare that is timely and effective,
despite the high-utilization. These individuals seek primary care diagnoses within the emergency rooms,
where they can ensure a free treatment, rather than scarcely located private physicians.

The policy to amend the problem:

State supported Medicaid will utilize the cooperation of medical professionals and advocates to
bring community-based care to residents of health hot spots through Affordable Care Organizations
(ACOs). ACOs are a network of healthcare professionals from every level that share responsibility of the
quality care of residents in certain areas. Nurses and social workers will coordinate routine wellness
check-ins and ensure residents are taking their medications to create primary preventions through positive
health behaviors. For example, by confirming that patients engage in a healthy diet and regimen, chronic
diseases and expensive treatments can be easily avoided. The extreme cost for treatment of chronic
diseases in Medicaid beneficiaries will not be placed on state funding because primary prevention will
prevent the diseases manifestations. The reason these ACOs will successfully combat this facet of the
problem is because the coordination teams tackle specific geographic areas to instill these behaviors with
realistic and attainable health outcomes. The specificity of this policy allows care to be more intimate and
personalized with residents in these areas. Thus, the high utilizers will be given care that does not require
constant costly re-hospitalization.

I expect my Opinion Editorial piece to be presented to residents in potential health hot spots
across the state. By showing these residents an advocates opinion, supported by data and examples, there
will be an increase in their awareness of the available resources for health related issues. The New Jersey
Department of Health should also include this piece as an example of as well as private insurance

companies that can provide financial assistance for Medicaid ACOs. Private insurance companies can
partner with the non-profit ACOs to reap the financial benefits that result from improving the health of
residents in health hot spots. As long as the health of citizens within the ACO adheres to specific quality
metrics, all parties involved will profit. New Jersey Health Department can benefit from this piece
because it can enlighten officials of health issues in the most dangerous areas of the state. Officials may
elect to support ACOs through policy or cooperation with their shared goals. These organizations will
only flourish with extreme support that shifts the publics view of health toward the wellness of an
individual resident, rather than the security of a medical professional. Therefore, I hope the opinion
editorial piece will reach the meetings within the state department, city council discussions, or even
public forums in areas that need attention to that provided by the ACOs.
I aimed my video toward the audiences of people within the health hot spots. I think this can
create change because it can educate residents on the available resources. This will be effective because
the video describes a situation with which these residents may empathize. I also included videos that
highlight the steps already taken in hot spots in response to the lack of community health knowledge.
These videos convey a sense of community-based support that will inspire residents to educate
themselves and their neighbors.
My information graphics will be published and presented to two major groups: within the state
departments and marketed toward private insurance companies. Professionals in these two areas play
pivotal roles in health policy implementation and regulation. The infographics will convince insurance
companies to partner with the non-profits to ensure the success of ACOs. Primarily, private insurance
companies will be convinced by the infographic because they will be attracted to the quantified healthrelated information. The images highlight areas that need help from ACOs, and show the need for health
professionals who are incentivized to make a significant difference in the area. This is because players in
the ACOs make a profit by sharing in the annual collected savings. These savings can increase if the set of
standards, or quality metrics, are met or exceeded each year. Quality standards include many expectations
from re-hospitalization rates to patient satisfaction with the provider. Once these quality metrics are

satisfied, the insurance companies can reap the substantial financial benefits of partnering with the nonprofit ACOs.
Further, officials in the state department and those who can regulate health policy will be affected
by the information graphics. These players will see the health hot spots desperately need government
involvement through effective change. By highlighting the lack of highly-utilized public hospitals in these
areas, the information graphic can convey a sense of urgency to the government officials. Also, the map
of the hot spots stresses the immediate dangers of these areas blending with each other, especially in
Essex and Hudson counties. If hot spots expand, the overall health of Medicaid beneficiaries in these
areas will worsen. Similarly, there is an information graphic that highlights the respondents who avoided
healthcare, despite being insurance holders or Medicaid beneficiaries. This will attract attention and raise
questions from state legislatures as to what is keeping these people from getting care.
I believe that all of the following have the capability to enact sustainable change: New Jersey
government officials, especially in the health department, private insurance companies interested in
participating in a new area of public health, and residents of these hot spots.