Horizon Blue Cross Blue Shield of New Jersey Expands Patient-Centered Programs, Delivering Better Care to More Than 750,000 Horizon Members

Newark, NJ, January 29, 2015 -- Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) announced the expansion of their patient-centered programs dedicated to improving patient care coordination, reducing unnecessary costs and improving the patient experience. The expansion means more than 750,000 members are now being treated by doctors in Horizon BCBSNJ’s patient-centered programs.

“Horizon is committed to transforming how health care is delivered in New Jersey,” said Robert A. Marino, chairman and CEO of Horizon BCBSNJ. “With this expansion, we continue to lead this effort with innovative doctors across this state, benefiting more than 750,000 of our members. We will continue to expand our patient-centered programs so that more of our members benefit from more coordinated and efficient patient care.”

The review of 2013 claims data demonstrate that patient-centered care works to improve the quality of care while lowering total health care costs. Claims data compared outcomes for more than 200,000 Horizon BCBSNJ members using patient-centered practices with outcomes for members using traditional primary care practices and found a: 

  • 14 percent higher rate in improved diabetes control.
  • 12 percent higher rate in cholesterol management.
  • 8 percent higher rate in breast cancer screenings.
  • 6 percent higher rate in colorectal cancer screenings.

Results also showed that more active care is being provided at a lower cost, as Horizon BCBSNJ members in patient-centered practices had a:

  • 4 percent lower rate in emergency room visits.
  • 2 percent lower rate in hospital admissions.
  • 4 percent lower cost of care for diabetic patients.
  • 4 percent lower total cost of care.

“Horizon’s patient-centered programs are working to lower costs and improve health outcomes,” said Jim Albano, Horizon BCBSNJ’s Vice President of Network Management and Horizon Healthcare Innovations. “We are pleased with the results and this program demonstrates how we can work with innovative doctors, hospitals, nurses, care teams, and make great strides toward delivering better care at a lower cost.”

“Patient-centered” care refers to an innovative approach where health insurance companies provide incentives to doctors to meet certain clinical quality, patient satisfaction, and efficiency benchmarks. Unlike the traditional fee-for-service model, patient-centered practices are also financially rewarded to improve the patient experience and improve patient care based upon national clinical guidelines.

Patient-centered practices provide patients with more coordinated and personalized care, including:

  • A care coordinator who provides additional patient support, information and outreach.
  • Wellness and preventive care based on national clinical guidelines.
  • Extra wellness support and education.
  • Active patient monitoring and communication from the doctor and care coordinator.
  • Active coordination of a patient’s care with specialists and other providers.

For a look into how a patient-centered practice is improving the patient experience, coordinating and personalizing the care for Horizon BCBSNJ members, click here.

There are more than 6,000 network doctors participating in Horizon BCBSNJ’s patient-centered programs. The patient-centered practices include doctors in Patient-Centered Medical Homes (PCMHs), Accountable Care Organizations (ACOs) and practices focused on Episodes of Care across New Jersey. To learn more about Horizon BCBSNJ’s patient-centered Programs, click here.

About Horizon Blue Cross Blue Shield of New Jersey 
Horizon Blue Cross Blue Shield of New Jersey, the state’s oldest and largest health insurer is a tax-paying, not-for-profit health service corporation, providing a wide array of medical, dental, and prescription insurance products and services. Horizon BCBSNJ is leading the transformation of health care in New Jersey by working with doctors and hospitals to deliver innovative, patient-centered programs that reward the quality, not quantity, of care patients receive. Learn more at http://www.HorizonBlue.com. Horizon BCBSNJ is an independent licensee of the Blue Cross and Blue Shield Association serving more than 3.7 million members.

Around the web

Compensation for heart specialists continues to climb. What does this say about cardiology as a whole? Could private equity's rising influence bring about change? We spoke to MedAxiom CEO Jerry Blackwell, MD, MBA, a veteran cardiologist himself, to learn more.

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”