Betsy Ryan is president and CEO of the New Jersey Hospital Association. Her blog, Healthcare Matters, examines the many issues confronting New Jersey's hospitals and their patients. Readers are encouraged to join the discussion, because healthcare matters - to all of us.

National Hospital Week: One Patient's Story

This week is National Hospital Week, and I have a very personal reason to celebrate.  A New Jersey hospital recently saved my life. Back in April, after a weekend of stomach pain that turned from very bad to unbearable, my husband drove me to our local hospital emergency department. I was quickly seen by a triage nurse and sent back immediately to the emergency room for an examination and tests. The diagnosis: a ruptured appendix that had spewed toxins throughout my body. I was rushed to the operating room at 1 a.m. and infused with antibiotics to help my body fight the toxins.

It was an experience you never anticipate ahead of time, but when it came for me and my family, we were so grateful to have quick access to round-the-clock hospital care. My physicians, nurses and patient technicians were terrific caregivers. It took my body a long time to fight back and get healthy -- nearly two weeks, in fact, before I was well enough to be discharged. But my caregivers were there at all hours, monitoring my status, administering medications and explaining to me and my large family what was happening. I was so sick I didn't realize the severity of the situation, but my body began to respond with the help of excellent care and strong meds. I thank all of the healthcare professionals who cared for me -- and all of the dedicated caregivers around the state who help patients like me. These compassionate individuals work just as hard at 3 a.m. as they do at 3 p.m., and on weekends and holidays as well.

This Hospital Week, I urge you to thank someone who works at your local hospital. You never know when you might need them.

Written by Betsy Ryan at 00:00

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For Patient Safety Week, a Salute to Healthcare Workers

March 2-8 is the national observance of Patient Safety Awareness Week, and I want to mark the occasion by thanking New Jersey’s dedicated healthcare professionals for ensuring the safety and well-being of New Jersey’s patients. Healthcare is the state’s second largest source of jobs, so there are many of you out there whose constant dedication and commitment creates an environment of caring and healing.

Here in New Jersey, we have plenty of reasons to celebrate this week: All of New Jersey’s acute care hospitals have joined the national Partnership for Patients effort, which is dedicated to improving patient safety and providing quality healthcare. As part of this initiative, New Jersey hospitals have made great strides in attacking the number of adverse events that can sometimes complicate a hospital stay. They’ve reduced infection rates, pressure ulcers, pneumonia rates, medication errors and complications during labor and delivery. In addition, New Jersey has one of the nation’s largest number of hospitals to receive the coveted “Magnet” designation for nursing excellence.

To New Jersey’s healthcare professionals: You should take great pride in the work you do each day, providing high quality, compassionate patient care to those in need.

This year’s Patient Safety Awareness Week theme is Navigate Your Health…Safely, reminding us all that providing safe patient care requires our commitment 365 days a year. And patients are an important part of that equation. We encourage you to be engaged in your healthcare: Be active, ask questions, keep notes. It’s all part of the very important partnership between providers and the people they serve.

Written by Betsy Ryan at 00:00

Being Blogged

I must confess that blogging about healthcare issues (and occasionally other things) can be fun. But nothing beats having the U.S. Department of Health and Human Services blogging about something good your own organization is doing. This past Tuesday (in between snowstorms) Secretary Kathleen Sebelius visited Jersey City and met with Mayor Steve Fulop and a Navy veteran named Hilda De’Mello, who NJHA recently hired and trained as a certified application counselor to assist people in enrolling for health insurance coverage. NJHA hired a total of 25 veterans for this important work in a program made possible through a one-year grant from the Robert Wood Johnson Foundation’s New Jersey Health Initiatives. It’s a great partnership. We’ve been able to hire 25 people who have already served their country, to serve it yet again in a different capacity – enrolling people in ObamaCare. 

You can read HHS’ post here. We thank Secretary Sebelius and her team for blogging about Hilda and our efforts to directly enroll people through the Health Insurance Marketplace. One thing the blog didn’t include was that Hilda was surprised to be called up to speak to reporters and others who had gathered for the event. But you’d never know it – she was composed, articulate and did a great job. (Go Navy!) Thanks Hilda, and thank you to Secretary Sebelius for sharing our program with readers across the nation. Thanks also to Mayor Fulop for his efforts to have multilingual college students reach out to the diverse population of Jersey City to urge them to obtain enrollment.

Written by Betsy Ryan at 00:00

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Hospital Charges: What Healthcare Consumers Need to Know

We appreciate consumers’ concerns about healthcare costs, and it’s understandable that folks are alarmed when they see yet another report on hospitals’ high “charges.” But what those reports often fail to say is that charges are largely irrelevant to the vast majority of healthcare consumers. If you don’t mind, I’d like to take this space to try to add some helpful perspective for New Jersey healthcare consumers.

“Charges” are a price point listed on paper but actually are used very little in the real world. A 2009 state law caps the amount of hospital charges an uninsured individual must pay, and the vast majority of hospital payers such as insurance companies, Medicare and Medicaid all pay hospitals at rates much, much lower than these posted charges for the care they provide to you. In fact, about 62 percent of all claims for inpatient hospital care are covered by the government programs Medicare, Medicaid and charity care – and all three of those programs pay hospitals at rates that are less than it actually costs to deliver that care. Historically speaking, that’s one of the reasons charges have risen over the years – so hospitals could try to offset the losses that mount when they are underpaid by so many other programs.

Here’s why charges are increasingly irrelevant:

  • A 2009 state law caps hospital charges for most uninsured patients at 115 percent of Medicare rates (and since Medicare reimburses hospitals an average of 91 percent of costs, that’s just slightly more than break-even.) These protections apply to individuals earning up to 500 percent of the federal poverty level – or up to $117,750 annually for a family of four.
  • In the end, only about 4.5 percent of N.J. hospital consumers may potentially be billed at charges. These are the individuals who earn too much to qualify for a government-subsidized insurance program and who opt not to purchase insurance on their own.
  • That small pool of uninsured individuals who may be billed at charges is expected to dwindle even further as more individuals are insured under the Affordable Care Act.

Yes, it’s complicated, and we admit that hospital charges don’t make much sense. No one actually designed this system; it just evolved over time as hospitals tried to adapt and survive in our broken reimbursement system.

For New Jersey healthcare consumers, the important thing to know is this: Whether you are covered by Medicare, Medicaid or private insurance, the rate paid to your hospital is much, much lower than these posted charges. And if you are uninsured, your obligation is capped by state law. N.J. hospitals also have signed on to a set of voluntary compassionate billing guidelines to work with those without insurance. Call your hospital if you are having trouble paying a medical bill to discuss the potential for discounts or a payment plan.

Written by Betsy Ryan at 00:00

NJHA Brings in the Reinforcements for ACA Enrollment Woes

The Health Insurance Marketplace at has had a rough launch, no doubt about it. Fixes to the site are supposed to be in place by the end of the month, but clearly the impact has already been felt in the disappointing early enrollment figures. While the Obama Administration had aimed for 500,000 enrollees in the first month, the actual tally was a mere 106,000. We need to do better in insuring more Americans.

Here in New Jersey, we’re calling in reinforcements. On Monday, Veterans Day, NJHA officially announced its new effort to hire 25 U.S. veterans to serve as Certified Application Counselors and assist N.J. residents in enrolling for new coverage options under Medicaid, NJ FamilyCare and the Health Insurance Marketplace. Our first team of CACs have been hired, trained, certified and are already working in the field answering questions and assisting individuals. They’re prepared to assist in enrollment via paper form, telephone or online. Having met several of these veterans, I can tell you that they are up to the task – they are committed, determined, goal-oriented, service-minded problem solvers. They are the right men and women for the job. As the daughter of a Navy Seabee, the sister of a Navy Seabee, the wife of a Naval Officer and the sister-in-law of two Marines, I am proud to play just a small part in this program.

If you’re struggling with your options under the Affordable Care Act, our platoon is ready to assist. We’re in the process of scheduling our teams of CACs in healthcare facilities and other locations across the state. Additional information and a schedule of enrollment events can be found on the Get Help page of our Healthcare Reform Resource Center  at We’ll be updating it regularly as additional events are scheduled throughout the year, so check back often for a location near you.

Written by Betsy Ryan at 00:00

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