; Horizon Blue Cross Blue Shield Of New Jersey Expands Medical Home Program Driving Quality And Affordability
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Press Release

Horizon Blue Cross Blue Shield Of New Jersey Expands Medical Home Program Driving Quality And Affordability

February 6, 2013

NEWARK – Horizon Blue Cross Blue Shield of New Jersey today announced the expansion of its patient-centered medical home (PCMH) program.  Under the expansion, an additional 45,000 Horizon BCBSNJ members, for a total of 200,000 members, will be served by medical home practices. 

Early results of Horizon BCBSNJ medical homes indicate an 8 percent higher rate in improved diabetes control and a 6 percent higher rate in breast and cervical cancer screenings for medical home patients compared to patients in practices that are not participating in the medical home program. In addition, medical home practices obtained lower rates in avoidable emergency room visits and hospital readmissions for their patients.  Over the long term, if these results hold and more Horizon BCBSNJ members are served by medical homes, it will work to slow the growth of health care costs and premium increases.

“Our commitment and goal is to transform how health care is delivered in New Jersey through incentives that reward quality of care, rather than volume of care, and slow the growth of health care costs. Our medical home program is making early progress toward those goals,” said Robert A. Marino, Chairman and CEO, Horizon BCBSNJ.

The PCMH program began in January 2011 and the collaboration between Horizon BCBSNJ and its network physicians continues to grow. Approximately 700 Horizon BCBSNJ network physicians and health care professionals, at more than 300 locations, will be participating in medical homes as a result of this expansion.

“This important collaboration with physicians to create medical homes is helping change how we work together to improve the quality of care and reduce unnecessary health costs for Horizon BCBSNJ members throughout New Jersey,” said Jim Albano, Vice President, Network Management and Horizon Healthcare Innovations, Horizon BCBSNJ. 

In a medical home practice, physicians take on greater accountability to provide their patients more comprehensive, coordinated care. Medical homes physicians are rewarded for providing evidence-based preventive health screenings and wellness care for their patients to improve health outcomes and hold down long-term costs. 

Under the PCMH program, Horizon BCBSNJ initially provides participating practices with upfront funding to hire Population Care Coordinator nurses that work to engage and empower patients to take control of their health. Participating PCMH practices also have an opportunity to receive additional outcome-based payments, provided they meet specified goals for quality care, increased patient satisfaction, and lower costs.

To find participating doctors and primary care practices, 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 services corporation, providing a wide array of medical, dental, and prescription insurance products and services.  Horizon BCBSNJ is an independent licensee of the Blue Cross Blue Shield Association, serving 3.6 million members with headquarters in Newark and offices in Wall, Mt. Laurel, and West Trenton.  Learn more at www.HorizonBlue.com.

The Blue Cross and Blue Shield Association is a national federation of 37 independent, community-based and locally-operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for more than 105 million members – one-in-three Americans.  For more information on the Blue Cross and Blue Shield Association and its member companies, please visit bcbs.com. We encourage you to connect with us on Facebook, check out our videos on YouTube, follow us on Twitter and check out The BCBS Blog, for up-to-date information about BCBSA.