July 24, 2013 Vol. 22 No. 926
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Applies to: All markets
Delivering better, cost-effective care
2012 results show positive outcomes in our patient-centered practices
Innovative new models of care are beginning to transform the delivery of health care benefitting patients and lowering costs, according to results from one of Horizon Blue Cross Blue Shield of New Jersey’s patient-centered programs. The 2012 Patient-Centered Medical Home Program (Program) results show that patient-centered physician practices are improving the coordination of care and reducing unnecessary complications for their patients.
“Our positive 2012 results demonstrate that health insurers and physicians can work together to transform how care is delivered to benefit patients and lower costs,” said Jim Albano, Vice President, Network Management and Horizon Healthcare Innovations, Horizon BCBSNJ.
Horizon BCBSNJ compared how health care was delivered to 70,000 members in patient-centered practices to the health care delivered to members in other primary care practices. The results showed impressive improvements in care and reduced costs to those members in the Program, including:
Providing better care
• 5 percent higher rate in improved diabetes control (HbA1c).
• 3 percent higher rate in breast cancer screenings.
• 11 percent higher rate in pneumonia vaccinations.
Utilization and cost measures
• 23 percent lower rate in hospital inpatient admissions.
• 12 percent lower rate in Emergency Room (ER) visits.
• 9 percent lower cost of care for diabetic patients.
“Under this collaborative medical home program, patient care coordinators have helped to create personalized care plans for patients at high risk of complications from their illnesses, which is working to produce improved quality outcomes,” said Dr. Roger Thompson of Integrated Medicine Alliance in Monmouth County. “This initiative has helped us deliver proactive outreach programs to discover obstacles to proper care, fill gaps in care and to engage patients and encourage participation in making their own health care decisions.”
Participating physicians in the Program focus on actively improving care coordination among a patient’s treating physician as well as promoting preventive and wellness care. Horizon BCBSNJ members in the Program receive:
• Quality, personalized and team-based care led by a physician.
• Coordinated care, from start to finish.
• Follow-up primary care immediately after an ER visit or hospital discharge.
• Improved access to care when needed most.
• Enhanced communications with their care team.
• Wellness and preventive care based on national guidelines.
• Extra support and resources – including health education.
“The momentum from our early successes makes it possible to expand our program so that an additional 80,000 Horizon BCBSNJ members can experience the benefits of improved care coordination,” added Albano. “We’re committed to the transformation of care in New Jersey and to having most of our members in patient-centered practices within a few years.”
Horizon BCBSNJ has a number of patient-centered programs, including Accountable Care Organizations, Patient-Centered Medical Homes and programs focused on Episodes of Care (i.e. joint replacement). More than 320,000 members and 1,400 doctors are participating in Horizon BCBSNJ’s patient-centered programs that are working to improve patient care while controlling costs.
If you have questions, please contact your Horizon BCBSNJ account executive or account manager.