CentraState Healthcare System announced Wednesday it will be designated as a Tier 1 hospital for all Horizon Blue Cross Blue Shield of New Jersey OMNIA health plan members effective immediately.
The designation means greater access to CentraState’s care for New Jersey patients with Horizon BCBSNJ OMNIA coverage, for less cost.
OMNIA Health Plan members incur lower out-of-pocket costs, sharing expenses when they access care from OMNIA Tier 1-designated hospitals, physicians and ancillary providers and services.
CentraState is currently participating in Horizon’s network, but had been in OMNIA Health Plans as a Tier 2 hospital.
“Providing our communities with affordable, patient-centered quality care has always been our priority,” said John Gribbin, president and chief executive officer of CentraState Healthcare System. “Broadening our collaboration with Horizon enables CentraState to better fulfill its mission of delivering integrated care to our community while providing affordable access to more OMNIA health plan members,” Gribbin said.
Last year, both CentraState and Horizon BCBSNJ announced the accelerated development of value-based care initiatives at CentraState by collaborating on “Episodes of Care” programs for orthopedics and maternity care, integrating Horizon’s patient-centered, value-based care models into CentraState’s existing efforts to improve the health and well-being of its patients.
In October 2018, CentraState withdrew as a plaintiff in a lawsuit challenging BCBSNJ’s OMNIA plans.
At the time, a joint statement from CentraState and Horizon stated that as part of the agreement the entities would collaborate on the “Episodes of Care” initiatives at the Freehold-based health system beginning in 2019.
The original suit, filed in 2015, claimed CentraState, Valley Health System and Holy Name Medical center were unfairly excluded from Tier 1 status in the plans.
Valley Health also settled its suit in October 2018, while Holy Name ended its legal battle in June of that year.
CentraState recently announced a clinical affiliation with Atlantic Health System focusing on specific service lines that will further advance value-based care initiatives.