Log In to The Paramus Post - Greater Paramus News and Lifestyle Webzine

Please enter your user name and password below.

No Account Yet? Sign Up!

The Paramus Post - Greater Paramus News and Lifestyle Webzine
Wednesday, September 18 2019 @ 03:17 AM EDT
The Paramus Post - Greater Paramus News and Lifestyle Webzine
Wednesday, September 18 2019 @ 03:17 AM EDT
The Paramus Post - Greater Paramus News and Lifestyle Webzine

Horizon Blue Cross Blue Shield of New Jersey collaborates with patient-centered doctors to improve care, contain health care cos

Sixty percent of Horizon’s medical spending in NJ now going to its patient-centered network doctors and hospitals
(September 6, 2016, Newark, NJ) – Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) announced today that more than one million members are now benefiting from patient-centered programs that incentivize doctors and hospitals to achieve better care coordination and improved care quality while reducing costs.  In 2015, patient-centered practices and hospitals received $58.9 million in care coordination and shared savings payments for reaching quality and savings goals.  These value-based payments were in addition to what the providers were paid through traditional fee-for-service reimbursements.

“Patient-centered care is delivering real results for our members in terms of improved quality outcomes and it is lowering the overall cost of care.  Horizon is committed to patient-centered care and transforming health care delivery in New Jersey to a fee-for-value model,” said Allen Karp, senior vice president, Healthcare Management for Horizon BCBSNJ. “The level of financial support to our patient-centered, value-based providers speaks volumes about our commitment to a better, more cost-efficient delivery system in New Jersey.”

For 2015, Horizon BCBSNJ reviewed claims data for members receiving care from a patient-centered provider and compared those findings to members receiving care from traditional providers.

The results show that patient-centered members, as compared to those members in traditional practices, had a:

  • 12 percent lower cost of care for members with diabetes.
  • 2 percent higher rate in breast cancer screenings.
  • 5 percent lower rate of emergency room visits
  • 2 percent lower rate of hospital admissions

“Patient-centered practices are not only helping Horizon members better manage and prevent diseases, they’re helping to bend the health care cost curve by reducing unnecessary ER visits, in-patient admissions, duplicative testing and other inefficiencies that don’t contribute to better care quality,” Karp said.

Patient-centered practices helped patients avoid more than 3,500 ER visits in 2015, resulting in a projected savings of over $2.6 million.

Practices are also credited with helping members avoid more than 400 inpatient stays – which would otherwise cost more than $4 million.

There are more than 4,100 primary care network doctors and thousands of specialist doctors in Horizon BCBSNJ’s patient-centered programs. These providers in 2015 received a total of $28.9 million in care coordination fees and $30 million in shared savings for a total of $58.9 million in value-based payments from Horizon BCBSNJ. Since 2013, Horizon BCBSNJ has made $125 million in value-based payments to its patient-centered providers.

The purpose of Horizon BCBSNJ’s patient centered practices is to 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.

Approximately 60 percent of all Horizon BCBSNJ medical claims spending in New Jersey during 2015 went to patient-centered network doctors and hospitals that are improving the quality of care for Horizon BCBSNJ members, while controlling costs and improving the patient experience.

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 www.HorizonBlue.com. Horizon BCBSNJ is an independent licensee of the Blue Cross and Blue Shield Association serving more than 3.8 million members.


Share It!

Comments are closed
Trinity Presbyterian Church
Join the purpose driven church exercising faith, hope, and love because nothing else matters...
StoneMicro Web Technologies
Dynamic Website Development, Content Management System, Blogs, Web design, Web hosting services
Sponsor ParamusPost