New Jersey is fortunate to be home to world-class hospitals and integrated health care systems. These institutions are especially keen to remind New Jerseyans of their capacity to provide one-stop shopping for all health care needs, as one is likely to have noticed through prolific advertising during broadcasts of major sporting events, in mass transportation venues, and on billboards along the parkway and turnpike. If nothing else, the tremendous growth of New Jersey’s health care systems has facilitated the ability for patients to receive truly clinically integrated health care service, with hospitals and providers across the full spectrum of medical specialties working collaboratively to keep patients healthy.

Yet the trend toward increasing clinical integration and overall patient health care management does not happen in a purely altruistic vacuum. For decades now there has been a public policy push, most often at the federal level, to move health care delivery (especially in the context of Medicare and Medicaid) toward value-based care (VBC) arrangements. In Medicare, following passage of the Affordable Care Act in 2010, the Centers for Medicare and Medicaid Studies (CMS) implemented the first Accountable Care Organization (ACO) program, in which clinically integrated physician networks assumed responsibility for overall patient health and became financially incentivized to maintain or improve patient health and reduce fee-for-service (FFS) payments due for treatment of attributed Medicare patients. By the end of 2022, over 11 million traditional Medicare patients were under the care of an ACO through the Medicare Shared Savings Program, over 573,000 clinicians across the country participate in an ACO, and CMS is actively striving toward a goal of having 100% traditional Medicare recipients covered by an ACO by 2030.