Horizon BCBSNJ's 2013 Study Results Demonstrate Patient-centered Program Improves Patient Care and Lowers Costs
July 22, 2014
Newark, NJ -- New study findings released today confirm that Horizon Blue Cross Blue Shield ofNew Jersey's patient-centered program is working to improve the coordination of care and lower costs. The 2013 patient-centered study is the largest to date and includes more than 200,000 Horizon BCBSNJ members. Patient-centered care is an innovative approach that focuses on delivering better quality outcomes, a better patient experience and lowering the cost of care.
"Our most recent study results clearly demonstrate the value of the patient-centered model, which will continue to improve and transform health care inNew Jersey," saidJim Albano, Horizon BCBSNJ's Vice President of Network Management and Horizon Healthcare Innovations. "The results also demonstrate the commitment of our participating doctors, nurses and care teams, and we look forward to expanding these efforts to benefit more of our members."
The 2013 study of claims data for more than 200,000 Horizon BCBSNJ members in participating patient-centered doctors' offices shows that patient-centered practices are performing better than traditional practices in a number of clinical metrics. The study compares members in traditional primary care practices with those practices participating in Horizon BCBSNJ's Patient-Centered Medical Home Program and found that patient-centered members had 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.
The study also shows 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. Members under the care of a patient-centered practice were also able to avoid more than 1,200 emergency room visits and 260 inpatient hospitals admissions, which represent a savings of approximately $4.5 million. 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. "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.
There are more than 3,700 network doctors in 900-plus patient-centered practice locations in Horizon BCBSNJ's patient-centered programs. The patient-centered practices include doctors inPatient-Centered Medical Homes(PCMHs), Accountable Care Organizations (ACOs) and practices focused on Episodes of Care acrossNew Jersey.
Horizon BCBSNJ recently intensified its commitment to patient-centered care by introducing two new patient-centered health plans for small businesses with 50 or fewer employees. The new plans encourage members to use patient-centered practices and are Horizon BCBSNJ's lowest cost small employer plans at the Bronze and Silver levels. The premiums are 15% lower than the company's other plans.
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 and Blue Shield Association, serving 3.7 million members with headquarters in Newark and offices in Wall, Mt. Laurel, and West Trenton. Learn more at http://www.HorizonBlue.com.
The Blue Cross and Blue Shield Association is a national federation of 36 independent, community-based and locally-operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for 107 million members 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.