Linda Schwimmer, President & CEO, New Jersey Health Care Quality Institute (NJHCQI)

In an interview with Invest:, Linda Schwimmer, president and CEO of the New Jersey Health Care Quality Institute (NJHCQI), discussed the organization’s role as a multistakeholder convener driving improvements in health care safety, quality, and affordability. “We engage all key players to address systemic gaps without advocating for any single sector,” Schwimmer said.

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What is your overview of the New Jersey Health Care Quality Institute, and what changes and achievements over the past year have most impacted the Institute?

We are a multistakeholder organization focused on convening and bringing together our over 120 organization members. Our members represent every sector of healthcare, including patient advocates, community activists, and health workers, ranging from nurses and doctors to hospitals, pharmaceutical companies, insurers, healthcare technology companies, and more. Essentially, we engage with all key players in healthcare and collaborate with them to improve the safety, quality, and affordability of healthcare. I am grateful that our members consistently look beyond their individual roles and organizational interests to consider how we can collectively improve the health system for everyone in New Jersey.
We are structured into three primary divisions. The first is public policy, where we work closely with our members as well as policymakers at the federal, state, and local levels — though primarily at the state level. Healthcare is highly localized, and we play a unique role in addressing systemic issues without advocating for any single sector.

The second division is quality improvement, led by a registered nurse (RN) who has earned a Master of Science in Nursing (MSN) degree and is a healthcare quality and patient safety expert. We work directly with healthcare providers to enhance care quality and improve patient safety. Our current areas of focus are on mental health and maternal-child health. 

The third division is community health, where we run the Mayors Wellness Campaign in partnership with the New Jersey League of Municipalities. New Jersey has over 500 municipalities, and we collaborate with more than 400 of these cities and towns. Mayors pledge to improve residents’ health, and we provide them with technical assistance, tools, and resources. This year, we launched a new hub for mayors to communicate, share resources, and seek assistance; an effort that has significantly improved the quality of these community health and wellness initiatives.

Regarding changes throughout 2024, mental health has been a major focus since COVID-19. Through focus groups across all 21 counties, we consistently heard about the need for mental health support, stigma reduction, and resource accessibility. We run an international program called Mental Health First Aid and recently developed a specialized Perinatal Mental Health First Aid training for those working with pregnant and postpartum patients. This program addresses maternal morbidity and mortality linked to mental health, and we train doulas and community health workers. It has been highly successful, with over 90 percent of participants feeling better prepared to assist clients experiencing a mental health crisis. 

Additionally, our state invests heavily in children’s mental health services, but the various state-funded systems can be disconnected and confusing to access. We are conducting a landscape analysis to identify strengths as well as opportunities to improve access and coordinated care. This long-term project will provide valuable insights for the next administration.

Another critical area is bolstering the healthcare workforce. Our members consistently report challenges in hiring and retaining professionals. We co-lead the Essential Jobs Essential Care New Jersey Coalition, using data to identify workforce needs, demographics, and aging trends. We collaborate with community colleges and high schools to promote healthcare careers and are working to streamline licensing and credentialing processes to reduce regulatory burdens. Both 2024 and 2025 have been busy years, and, with leadership changes in the state, we expect even more activity.

What distinguishes New Jersey’s healthcare landscape from other states, and how does NJHCQI help drive that differentiation?

Let me start with the second question. Our board chair, who works at a national company, has noted that no other state has an organization like ours. We serve as a convener, bringing stakeholders together to address complex issues. Members, including hospital systems, value our events and working groups because they provide a rare opportunity to collaborate across sectors toward common goals. We bring people to the table who may not ordinarily communicate with each other. This consensus-building approach is unique and could serve as a model for other states.

As for New Jersey’s healthcare landscape, there are several positives. We are a leader in healthcare coverage and subsidies. Our Medicaid program is one of the most generous in the country, and we provide substantial subsidies for the Affordable Care Act marketplace, significantly reducing the number of New Jersey residents who live without health insurance. Our hospital systems are also high-quality. Through The Leapfrog Group, a national nonprofit organization that I currently chair, we have pushed hospitals to prioritize transparency and safety. New Jersey is the only state where 100% of hospitals voluntarily report on the Leapfrog Hospital Safety Survey. This transparency has driven competitive quality improvement, and now most New Jersey hospitals earn A or B grades on the Leapfrog Survey.

Another strength is our work on maternal and infant health. First Lady Tammy Murphy’s Nurture NJ campaign has brought unprecedented attention to maternal health disparities. We have partnered with her office, the Department of Health, and other agencies to allocate resources and implement programs that address these gaps.

However, challenges in New Jersey remain. Despite high rates of insurance coverage, provider networks and access for some types of care are an issue, partly due to reimbursement levels and licensing barriers. Additionally, disparities in access and equity persist based on income, race, ethnicity, and language. A concerning national trend is the reduction in health equity data collection, which hampers efforts to address disparities. Without data, it is impossible to measure or mitigate these gaps. We advocate for continued data collection and investment in health equity. Addressing structural barriers and disparities in healthcare will improve the vibrancy of our communities for everyone. 

How is NJHCQI helping to promote innovative technology, such as digital health tools and AI?

Artificial intelligence is on everyone’s mind. For now, AI will likely be most helpful with administrative tasks, such as billing, coding, and submissions to insurance companies, including the back-and-forth disputes. It may also replace traditional methods like scribes or Dictaphones. Predictive modeling is being tested and used, though there is some apprehension. All of this will factor into healthcare, which has been one of the last industries considered scalable due to its deeply personal nature and the need for human interventions.

The goal is for AI to reduce administrative burdens so doctors and nurses can spend more time with patients. How AI will be used for decision-making is exciting, but people are concerned about putting in safeguards and how existing biases could be built into those systems.

Patient monitoring and telehealth visits, such as Zoom appointments, have been a fantastic advancement. Mental health apps already show great promise. For example, we have a new member who created an app designed for mental health support for pregnant women. Not everyone requires direct counseling, though, and some may use the app for basic coaching or meditation. There are different levels of care, and technology can help meet those needs.

I also want to highlight a recent initiative. The Quality Institute led a workgroup focused on comprehensive primary care, examining how the state could better support primary care providers. The group included mental health providers, health plans, primary care physicians, and geriatricians. They discussed challenges such as excessive time spent on data collection and reporting, and they outlined proposed solutions. The group developed a measure set for adult primary care and recommendations for improved data sharing between health plans and providers. Dr. Alfred F. Tallia from Rutgers, who chairs family medicine there, described the report we released as a must-read for gubernatorial candidates, calling it a blueprint for strengthening primary care in the state.

What is your outlook for New Jersey’s healthcare system, and the NJHCQI’s role in shaping this outlook over the next three to five years?

The direction of the state’s healthcare system will largely depend on leadership, particularly the next governor. Two major issues will be the Medicaid program and how it is sustained or modified based on federal funding. Another critical concern is the New Jersey State Health Benefits program, which provides health insurance for state employees and their families and is among the top five areas of state spending. If federal funding decreases, these programs will need significant attention. Currently, they are in a crisis. Given my background in health insurance, I expect we will be providing extensive advice to policymakers on the real challenges ahead.

On the healthcare delivery side, supporting primary care remains a priority. When I say primary care, I include reproductive health, maternal health, pediatrics, mental health, and oral health, which is often overlooked. We recently conducted a secret shopper audit of NJ Medicaid dental directories for young children and found that over 51% of listed dental offices would not see young children, despite recommendations for early oral care. This is unacceptable, as dental health is critical to overall well-being. We will continue advocating for comprehensive primary care, as that is the foundation of overall good health and health equity.