Horizon Blue Cross Blue Shield of New Jersey Expands Its Successful Medical Home Program To Benefit More New Jersey Residents

Horizon Blue Cross Blue Shield of New Jersey Expands Its Successful Medical Home Program To Benefit More New Jersey Residents

Horizon Blue Cross Blue Shield of New Jersey today announced a major expansion of its groundbreaking Patient-Centered Medical Home (PCMH) Program. Initiated in January 2010, Horizon BCBSNJ’s PCMH program is working to transform the state’s health care delivery system by changing incentive structures for providers to reward the value of care patients receive, rather than the volume of care.

In a collaborative effort with health care leaders, Horizon BCBSNJ is developing innovative resources to transform physician practices into medical homes as well as increasing accountability for providing patients with more comprehensive, coordinated care. PCMH practices also focus on ensuring their patients are receiving care that meets evidence-based guidelines for various preventive health screenings and wellness care.

Horizon BCBSNJ provides participating PCMH practices upfront funding to hire Population Care Coordinator nurses. Care Coordinator nurses work directly with physicians and office teams to improve the coordination of treatment for patients and help engage and empower patients to take control of their health. Once established, participating PCMH practices have an opportunity to receive additional outcome-based payments provided they meet specified goals for quality care, increased patient satisfaction, and lower costs.

Horizon BCBSNJ’s expansion will increase the number of members attributed to medical homes from 80,000 to 154,000. Forty-eight primary care practices at 145 locations are participating in this program. To view participating practices, click .

“With early results showing that Horizon’s collaborative medical home program is improving the quality of care and reducing health care costs, we want more of our members to benefit from the program,” said Jim Albano, Vice President, Network Management and Horizon Healthcare Innovations, Horizon BCBSNJ. “By the end of this year, we intend to have more than 200,000 members in Horizon’s medical home and accountable care programs.”

Early results of Horizon BCBSNJ’s PCMH program were positive. Horizon BCBSNJ members in medical homes received appropriate cancer screenings more frequently and showed greater improvement in controlling diabetes. In addition, medical home patients within the PCMH program had a 26% lower rate in Emergency Room visits and a 10% lower cost of care.

“The success of our to patient-centered medical home program and its expansion demonstrates Horizon’s commitment to working with health care professionals across the state to transform and improve how health care is delivered to patients in New Jersey,” said Robert A. Marino, Chairman and CEO, Horizon BCBSNJ.

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 .

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