How Horizon BCBSNJ is expanding its social determinants program amid COVID-19 

Horizon Blue Cross Blue Shield of New Jersey found success piloting a program targeting the social determinants of health in Newark. 

Now, the insurer is taking its Neighbors in Health initiative to 11 counties in partnership with some of the state’s largest health systems and digital health company NowPow. The Newark pilot was first launched in April 2017 in conjunction with RJWBarnabas Health. 

The program is built on deploying community health workers to meet members with social needs where they are and offer a local approach to meeting those needs. 

The expansion brings University Hospital, Trenton Health Team, Penn Medicine, Atlantic Health System, Hackensack Meridian Health and St. Joseph’s Health into the fold. 

Valerie Harr, director of policy integration, transformation and community health at Horizon, told FierceHealthcare that the insurer undertook a yearlong process to ensure bringing the program to scale was done in a thoughtful manner.  

Horizon earmarked $25 million to grow the program as part of the 2018 tax reform. 

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Horizon was able to use its influence as New Jersey’s largest payer to convene the partners in the initiative, Harr said, but the insurer also showed “humility” in acknowledging that it can’t tackle social concerns alone. 

“We’re sitting side by side and working through these things together and learning together,” Harr said. 

Horizon is planning to enroll 24,000 members in commercial, Medicaid and Medicare Advantage plans into the program. They’ll represent 11 counties in the northern and central parts of the state and 70 zip codes. 

NowPow’s platform will allow Horizon and its health system partners to manage networks of community resources and to track referrals to those resources. Having that care navigation element will close gaps in referrals and ensure members are receiving the services they need. 

Rachel Kohler, CEO of NowPow, told FierceHealthcare that one of the key benefits of the newly expanded program is that it will enable data-driven evaluation of the efficacy of community health solutions. 

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Putting data behind the value of these community organizations is a critical step toward making reimbursement for their work more widely available, Kohler said. 

“Our hope is that this then highlights the importance of the work that Neighbors in Health is doing,” she said. 

Expanding the program did run into a major hurdle this spring, however: the coronavirus pandemic. 

Harr said both Horizon and its health system partners paused to reconsider the launch but decided to move ahead as COVID-19 was having an outsized impact on the vulnerable communities Neighbors in Health targets. The program was also designed around a high-touch, face-to-face approach. 

There were also concerns that the health systems would have to pump the breaks on outreach as they treated COVID-19 patients—University Hospital in Newark, for example, was at the epicenter of the pandemic—but they were able to continue. 

They managed to take the program digital and are now providing community health services both over the phone and through video calls. 

“We weren’t sure our partners were even going to have the ability to continue to engage with us, but they did, which was fantastic,” Harr said. “We’re eager to have them back in the community but for now we’ve been able to pivot.”