The state’s largest health insurer, Horizon Blue Cross Blue Shield of New Jersey, saw a 50 percent increase in patient enrollments in its value-based, “patient-centered” programs in 2016.The state’s largest health insurer, Horizon Blue Cross Blue Shield of New Jersey, saw a 50 percent increase in patient enrollments in its value-based, “patient-centered” programs in 2016.
The total number of patients in those programs is now 1.5 million, and patients connected to the insurers value-based provider network accounted for 67 percent of all medical claims in 2016. Additionally, Horizon’s shared savings plans with participating providers – a system in which the insurer will reimburse doctors annually for providing high quality but cost-efficient wellness and preventative care – increased by 43 percent to $94.5 million in 2016.
Since 2013, Horizon BCBSNJ has made approximately $228 million in value-based payments to roughly 4,500 patient-centered providers it has in its network.
Overall, Horizon claims that in 2016, its value-based care programs resulted in:
- 3 percent lower total cost of care;
- 3 percent lower rate of emergency room visits;
- 3 percent lower rate of hospital inpatient admissions;
- 5 percent higher rate for colorectal screenings;
- 3 percent improved rate of diabetes control;
- 3 percent higher rate in breast cancer screenings, and
- 4 percent improved control of diabetes costs.
Horizon also claims that its patient-centered practices helped its New Jersey customers avoid more than 2,000 emergency room visits and more than 600 Inpatient stays in 2016.
“Since 2008, Horizon has been collaborating with a steadily increasing number of like-minded doctors and hospitals on innovative ways to change the way health care is delivered and paid for in New Jersey,” Allen Karp, Horizon’s vice preident of health care management, said in a press release. “The 2016 results are more proof that these collaborative partnerships are better for Horizon’s 3.8 million members, better for doctors and hospitals, and a better way to lower overall healthcare costs., The results achieved by the practices with the longest commitment to patient-centered care are solid evidence that these models will deliver meaningful quality improvements and cost reductions in the long-run.”
The insurer’s value-based practices actively coordinate the work of specialists and other health professionals and provide an increased focus on wellness and preventive care. “This active monitoring, engagement and communication helps patients get and stay healthy and avoid more costly, complicated and serious health conditions,” the company said in a written statement.
