New Accountable Care Organization to Improve Care and Lower Costs for 40,000 New Jersey Patients

New Accountable Care Organization to Improve Care and Lower Costs for 40,000 New Jersey Patients

Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) and Optimus Healthcare Partners (Optimus) today announced the launch of an Accountable Care Organization (ACO) agreement to deliver more effective care at lower costs to more than 40,000 Horizon BCBSNJ members. The new ACO agreement will include 42 primary care practices and 104 primary care physicians within 11 New Jersey counties.

“Horizon is committed to leading a transformation of New Jersey’s health care delivery system to improve the quality of care, increase patient satisfaction and reduce costs in collaboration with like-minded health care leaders,” said Jim Albano, Vice President, Network Management and Horizon Healthcare Innovations. “Collaborating with Optimus will allow us to deliver more effective, patient-centered care to more than 40,000 Horizon members.”

“Optimus Healthcare Partners’ physicians have embraced the need for care transformation, accountability, and the development of clinically integrated high performing physician networks,” said Tom Kloos MD, President and CEO of Optimus. “The goal of our organization has always been to deliver the highest quality of care to our patients. This partnership with Horizon will help support the processes at the physician level to achieve these goals.”

Under the ACO agreement, Horizon BCBSNJ will provide incentive payments to Optimus primary care physician practices to take on additional accountability for improving the health and patient satisfaction for its more than 40,000 Horizon BCBSNJ members. The incentive payments will support improved patient care coordination and fund other activities to further transform Optimus physician practices into patient-centered practices. Optimus physicians will have an opportunity to share in the resulting savings of the ACO, provided the practices meet certain health improvement, cost and patient satisfaction goals.

Optimus physician practices within this new ACO will be operating as Patient-Centered Medical Homes (PCMHs). The PCMHs is an aggressive approach to delivering health care that focuses on improving care coordination, as well as preventive and wellness care. Patients will receive personalized and comprehensive care through a lead physician, and care teams who are accountable for closely monitoring patient progress, engaging patients in their own health care and centrally coordinating the delivery of a patient’s care with other providers.

This initiative is open to Horizon BCBSNJ Commercial and Medicare Advantage members who use practices that are part of this ACO. To view a list of participating practices, go to .

Optimus Healthcare Partners is an Accountable Care Organization, founded by members of Vista Health System IPA, and Central Jersey Physician Network. In partnership with physicians of Morris Somerset IPA and Morris Area Integrated Physicians IPA, as well as Atlantic Health System, Optimus has developed a physician owned and managed organization of over 160 primary care physicians and over 370 specialists, capable of delivering the full spectrum of medical services to its patients. Optimus is also an early participant in the Medicare Shared Savings Program, the only independent physician run organization in the state to be accepted to date.

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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