Medicaid Report Card › State Rankings › New Jersey
Medicaid Report Card — State Snapshot
New Jersey
Overall rank
#44
of 50 states
Total score
32
out of 100
New Jersey performs moderately on program design indicators, including MCO presence, redetermination performance, and private coverage retention. The state also has some APCD activity and IMLC participation. Yet New Jersey’s overall score is constrained by Medicaid expansion, no early work requirement activity, weak program integrity scores, active CON laws, low primary care provider supply, and limited provider flexibility.
Strengths
MCO presence
Moderate redetermination performance and private-to-Medicaid coverage ratio
Some APCD activity
IMLC participation
Weaknesses
Medicaid expansion
No early work requirement activity
Weak improper payment and MFCU enforcement scores
Active CON laws and low primary care provider supply
At a glance
Quick facts
Expansion statusAdopted
Work requirementsNo
Redetermination rate70.9526% (Q3)
5-yr spending growth5.07% (Q4)
Per-enrollee cost growth2.01% (Q3)
Medicaid budget share11.2% (Q3)
Improper payment rate5.7% (Q4)
MFCU enforcement0.77 (Q2)
Score breakdown
Points by pillar
Program design & enrollment11/36
Fiscal sustainability & cost growth10/26
Program integrity & oversight7/24
Market structure & provider environment4/14
Total score 32 / 100
Pillar scores & metrics
Pillar 1
Program Design & Enrollment
11/36
Expansion status
Adopted 0
Work requirements (early activity)
No 0
Redetermination rate (lower = better)
70.9526% Q3 3
MCO presence
Yes 4
Coverage ratio (higher = better)
86.0815% Q4 4
Pillar 2
Fiscal Sustainability & Cost Growth
10/26
5-year spending growth (lower = better)
5.07% Q4 2
Per-enrollee cost growth (lower = better)
2.01% Q3 4
Medicaid budget share (lower = better)
11.2% Q3 4
Pillar 3
Program Integrity & Administrative Oversight
7/24
Improper payment rate (lower = better)
5.7% Q4 3
MFCU enforcement strength (higher = better)
0.77 Q2 2
APCD status
Strong Interest 2
Pillar 4
Market Structure & Provider Environment
4/14
Certificate-of-Need laws
Active CON Law 0
Primary care provider supply (higher = better)
245.6/100k Q1 0
NP scope of practice
Reduced Independent Practice 1
PA scope of practice
Moderate 1
IMLC participation
Member State 2
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