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Horizon to launch pediatric care coordination program

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Horizon Blue Cross Blue Shield of New Jersey, which now has 400,000 members getting medical care in patient-centered settings aimed at improving quality and lowering costs, announced Wednesday it is launching a new, family-focused program to improve the health of children.

The Patient-Centered Pediatric Program, the first of its kind by Horizon, will initially benefit more than 100,000 pediatric members. The initiative, launching on Jan. 1, 2014, will include more than 630 pediatricians and family practice doctors at more than 110 practice locations throughout New Jersey.

The program will be "focused on improving care coordination and delivering better quality outcomes for more than 100,000 pediatric members and their families," said Jim Albano, vice president of network management and Horizon Healthcare Innovations at Horizon.

Horizon collaborated closely over the past year with pediatricians, family practice physicians, practice managers and leadership of the New Jersey Chapter of the American Academy of Pediatrics to develop the program.

Fran Gallagher, executive director of the Academy's New Jersey Chapter, said the organization "applauds Horizon's innovative program to support investing in high-quality pediatric patient/family-centered health care. Pediatricians and parents of children with special health care needs alike have long recognized the need for comprehensive care coordination as a top priority in improving children's health outcomes — this program makes it possible."

Dr. Michael Schlitt is a pediatrician at Advocare Haddon Pediatric Group and vice president of payer relations at Advocare and Continuum Health Alliance, which have for the past 18 months "been involved in Horizon's Patient-Centered Medical Home Program, and we are excited to be participating in a similar initiative for our pediatric patients.

"The Patient-Centered Pediatric Program fits perfectly with the goals and programs we have been developing. We are excited to continue our collaboration with Horizon to enhance the delivery of coordinated, family-centered care to our pediatric patients and their families," Dr. Schlitt said.

Horizon said it is providing practices with the opportunity to receive payments for developing and updating care plans for their patients with chronic and complex conditions and for demonstrating better quality outcomes and reducing avoidable emergency room visits for their patients. Outcome-based payments are based on achieving specific quality outcomes, like ensuring children receive the appropriate immunizations and the use of appropriate treatment and medications for children with upper respiratory infections and asthma.


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