Introducing two innovative small business health plans that feature better care and lower premiums as part of New Jersey's largest network of patient-centered practices

Horizon Blue Cross Blue Shield of New Jersey is continuing its work to transform the way health care is delivered in the state by introducing two, innovative new health plans for small employers that encourage members to take advantage of the state’s largest network of patient-centered practices. The new plans will be available on July 1, 2014, and will be Horizon BCBSNJ’s lowest premium health plans for small employers. 

“Our new plans offer small employers lower premiums, and for their employees, lower out-of-pocket costs when they use innovative patient-centered practices that provide improved patient care,” said Christopher M. Lepre, Senior Vice President of Market Business Units at Horizon BCBSNJ. 

“Other health insurance companies have been talking about patient-centered care and lower costs, but Horizon has collaborated to build the largest network of patient-centered practices across New Jersey and, as result of improved care and lower costs, we are now offering small employers lower premium plans.” 

Early results of Horizon BCBSNJ’s patient-centered programs demonstrate that patient-centered care works to improve the quality of care, lower total health care costs and improve the customer experience. In 2012, Horizon BCBSNJ members that were in Patient-Centered Medical Homes had a 23% lower rate of hospital inpatient admissions, 12% fewer Emergency Room visits, and for diabetic patients, a 9% lower cost of care than members not in patient-centered practices. 

The new Horizon Patient-Centered Advantage EPO products (one Bronze and one Silver) are unique because when a member sees a primary care physician at a patient-centered practice in the Horizon BCBSNJ network their deductible ($2,500 Bronze and $2,000 Silver) does not apply, there is no co-insurance, and only a copayment ($40 Bronze and $20 Silver) is required at the time of service. In addition, the new Bronze plan premiums are approximately 15% lower than Horizon BCBSNJ’s current lowest priced small employer plan and the Silver plan premiums are approximately 15% lower than the current Patient-Centered Advantage EPO. “

Patient-centered” care refers to an innovative approach that provides incentives to physicians based upon the quality of patient care, rather than the quantity of care under the traditional approach. Patient-centered practices are paid more when they improve patient satisfaction and improve patient care based upon national clinical guidelines. Horizon BCBSNJ has the largest network of patient-centered practices in New Jersey, which include Patient-Centered Medical Homes (PCMH), Accountable Care Organizations (ACO), and practices that focus on a single Episode of Care (i.e. hip and knee replacement). 

There are more than 3,700 doctors at more than 900 patient-centered practice locations, including Patient-Centered Medical Homes (PCMHs), Accountable Care Organizations (ACOs) and practices focused on Episodes of Care, in the Horizon BCBSNJ network across New Jersey. More than 750,000 Horizon BCBSNJ members will be using a patient-centered practice by the end of this year. Patient-centered practices provide patients with more coordinated and personalized care, including:

• A care coordinator who provides additional patient support, information and outreach.
• Wellness and preventive care based on national clinical guidelines.
• Extra wellness support and education.
• Active patient monitoring and communication from the doctor and care coordinator.
• Active coordination of a patient’s care with specialists and other providers.