Gov. Phil Murphy has appointed Catholic Charities, Diocese of Trenton’s Director of Operations Susan Loughery to a statewide oversight board that was created to ensure community-based healthcare providers get adequately reimbursed for the mental health and addiction patients they treat.
Loughery (pictured, left) will serve as a member of the Mental Health and Addiction Fee for Service Transition Oversight Board, a 13-member panel charged with monitoring the state’s recent transition to a fee-for-service reimbursement system. The board will begin its work in February.
Previously, healthcare providers worked under annual contracts, meaning they got paid a set fee each year to provide treatment in the community. Under the new system, which launched in 2016, providers get paid per patient for specific treatments, after that treatment is provided.
The change, already made by many other states, was intended to increase federal Medicaid reimbursements.
A rocky transition
But many providers have found that treatment often costs more than what they recoup through reimbursement. In fact, the New Jersey Association of Mental Health and Addiction Agencies, or NJAMHAA (of which Catholic Charities is a member), found that reimbursement gap left 16 of its 17 member organizations struggling with deficits totaling more than $8 million in 2017.
Such losses drove some programs to cut staff, reduce services, or merge with other providers, despite an increased demand for community-based addiction and mental health care services, the association found.
The new oversight board was one of two measures former Gov. Chris Christie approved in May 2017 to address the fee-for-service transition’s rocky start. The other measure is an independent study of fee-for-service rates to gauge whether they need revision. NJAMHAA also supports a bill that would create a $25 million “fee-for-service safety net” intended to keep providers whole until the oversight board completes its work and the independent study is done.
“I’m grateful to Gov. Murphy and his staff for the opportunity to serve on this board overseeing this critical initiative,” Loughery said. “We intend to make sure services are available to all who need them under a sustainable system that improves health outcomes.”
Loughery has over 20 years of leadership experience in community behavioral health and human services, with expertise in the areas of Integrated Service Systems, Health Information Technology, Quality Assurance, Data Analytics, Risk Management, Human Resources, and Finance.
She joined Catholic Charities in 2015 and oversees all operations. She serves on NJAMHAA’s Board of Directors, is a member of the Trenton Health Team Board of Directors, and participates in national advocacy initiatives through Catholic Charities-USA. She holds a Master of Business Administration degree with a concentration in healthcare from The George Washington University in Washington, D.C.
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