Horizon, Optimus Healthcare launch patient-centered ACO

Horizon Blue Cross Blue Shield of New Jersey has launched a new accountable care organization (ACO) that will include 42 primary care practices and 104 primary care physicians treating more than 40,000 members.

Partnering with physician group Optimus Healthcare Partners, the new Horizon ACO will provide incentive payments for doctors who improve health outcomes and member satisfaction, CMIO reported.

Horizon is looking for participating doctors to comprehensively manage chronic diseases instead of just treating symptoms as they arise.

"We are looking for ACO partners that share our philosophy with creating a patient-centered medical home dominated marketplace, and a system like Optimus has a whole portfolio of specialists and primary care doctors working towards that goal," Horizon ACO Director Joe O'Hara told NJBiz. "Our care management services are powerful, but they're not as powerful as a physician working directly with a patient."

Horizon aims to meet with each individual doctor as they convert toward the patient-centered ACO, O'Hara said, because "sometimes, there are 14 physicians in one site, and other times, there are three sites with two physicians at each site, and they all have very different ways in how they engage with their patients."

"This is a very important type of relationship between the biggest payer in the region and a large physicians group. It's the marker for how we physicians are doing contracting with insurance companies in the future," David Shulkin, president of Morristown Medical Center and Optimus board member, told NJBiz. "If payers and providers in the state still thought nothing's going to change, I would be a lot more worried than I am now."

To learn more:
- see the CMIO article
- read the NJBiz article

Suggested Articles

A judge has dismissed the ongoing case between Oscar Health and Blue Cross Blue Shield of Florida over broker arrangements.

Expanding options for dental care in Medicare is a popular idea, but policymakers could take several avenues toward this goal, a new analysis shows.

Tennessee's proposal for a block grant brings a host of questions