; New Horizon Blue Cross Blue Shield Of New Jersey Product Brings Innovative Accountable Care Model To Employers
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Press Release

New Horizon Blue Cross Blue Shield Of New Jersey Product Brings Innovative Accountable Care Model To Employers

November 7, 2013

NEWARK – Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ), which has been leading an effort with physicians, hospitals and health care leaders throughout the state to transform how health care is delivered, has developed a new product for employers to encourage employees to use physicians focused on improving the value of care patients receive, rather than the volume of care. The goal of the new product is to increase the number of Horizon BCBSNJ members who will seek care in patient-centered practices to improve patient outcomes and reduce overall health care costs.

The new product – the Horizon Patient-Centered Advantage EPO Plan – is now being offered to fully-insured employer groups for coverage that becomes effective on January 1, 2014.

“Our Patient-Centered Advantage EPO Plan is another example of how we are leading the effort with doctors, hospitals, and now employers to transform how health care is delivered in New Jersey with a focus on the value of care, not the volume of care to improve patient outcomes and begin to control health care costs,” said Christopher M. Lepre, Senior Vice President of Horizon BCBSNJ’s Market Business Units.

More than 320,000 Horizon members and 1,400 doctors currently participate in Horizon’s patient-centered programs, including Patient-Centered Medical Homes (PCMHs), Accountable Care Organizations (ACOs) and Episodes of Care programs. The early results of Horizon’s patient-centered programs indicate the new approach is working with an increase in patient preventive care, 23% fewer inpatient hospital admissions, and 12% fewer emergency room visits.

“Our patient-centered programs reward physicians when the care they deliver produces better health outcomes, is better coordinated, and more efficient and this new product helps employers encourage their employees to take advantage of this new approach,” Lepre said.

The Horizon Patient-Centered Advantage EPO’s main difference from a traditional EPO plan is that it offers members lower co-payments for choosing a PCP from a list of participating patient-centered PCMH or ACO providers. Members who receive services from patient-centered practices will pay 66% lower co-payments than those who do not, or $10 rather than $30.

Horizon Patient-Centered Advantage EPO plan members receive:

  • Access to physicians who are working to transform health care delivery with a team of professionals, 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.
  • Proactive communication by the PCP to respond to member needs and monitor their health.
  • Access to PCPs who work closely with specialists, other medical providers and health care facilities to centrally coordinate a patient’s care.

Groups seeking more information about the Horizon Patient-Centered Advantage EPO, or looking to purchase the plan for their employees, should contact their broker or their Horizon BCBSNJ sales associate or account manager.

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 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.