Dr. Jeffrey Brenner has a plan. A primary care physician in South Jersey, Brenner is the founder and executive director of the Camden Coalition of Healthcare Providers, a nonprofit organization he established nine years ago to improve the medical treatment of Camden’s sickest residents.
Using his own system for tracking patient data, Brenner recognized that a small number of patients in the Camden area accounted for a disproportionately large chunk of health care costs. In response, he adopted a coordinated care approach, assigning nurses and other health and social services professionals to monitor individual high-risk patients. The goal was to avoid medical complications and reduce repeated emergency room visits and hospitalizations for the patients. Ultimately, Brenner says, this approach lowers health care costs while improving care.
For his bright idea and dedication, Brenner was recognized recently by the MacArthur Foundation as one of this year’s 24 MacArthur Fellows. A second New Jersey resident, Julie Livingston, a Rutgers history professor, was also honored. Each received a so-called “genius grant” of $625,000, to be paid over five years.
Brenner, 44, says some of the grant money will pay off loans that bogged down his former private practice. “I had a private Medicaid practice for many years and, toward the end, my rates kept getting cut,” he says. “I had to take a business loan to keep my doors open so I could continue treating patients. I was only being reimbursed $19 per visit for each Medicaid patient, and there are only so many patients you can see in an hour.”
Faced with a choice of throwing out his Medicaid patients or closing the office, Brenner chose the latter. “Paying back those business loans will be the first use of the grant money,” he says.
When he closed the doors of his private practice, another door opened, expanding his vision. Camden Coalition of Healthcare Providers has partnered with like-minded organizations, such as the Trenton Health Team and the Greater Newark Healthcare Coalition, to create a new network of key stakeholders and physicians who track and use data from hospitals and primary care offices in unique ways to solve local health care problems around the state, something all too rare in an industry not known for its problem solving.
How will Brenner measure the success of this endeavor in Camden?
“If we are succeeding, then the total spending on health care for Camden residents will go down over time,” he says. “We think that if the poorest city in the country can pull that off, it makes the rest of the country look silly. While there is a special place in heaven for those who give better health care at a lower cost, there is no business model or plan for it.”
Brenner blames some of the rise in health care costs on a lack of system-wide coordination. “Our political leaders need to think about whether the sight of a crane building a new hospital is a sign of success or a sign of failure. In [Central] Jersey, having two brand new hospitals just 10 miles apart—Capital Health Medical Center in Hopewell and University Medical Center of Princeton at Plainsboro—is a failure of leadership. It is redundant and wasteful. We should be using our resources more judiciously.”
How did Brenner react to being dubbed a genius by the MacArthur Foundation? “I was really surprised and feel very humble to personally receive the genius grant,” he says. “I’ve been in Camden for 15 years, and it is a pretty tough place to get anything done. Receiving this award is a vote of confidence in our work and focus, which is really all about delivering better care at a lower cost in one of America’s poorest cities.”
His heightened profile won’t alter Brenner’s commitment to Camden. “I am not going anywhere,” he says. “I am going to get this thing over the finish line. We want Camden to be the first city in the United States to actually reduce the cost and improve the quality of health care.”
