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Emphasis on 'patient-centered' health care is paying off, Horizon study finds

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Horizon Chairman and CEO Robert A. Marino: “The 2014 results further demonstrate how doctors, hospitals and Horizon are innovating and transforming health care.
Horizon Chairman and CEO Robert A. Marino: “The 2014 results further demonstrate how doctors, hospitals and Horizon are innovating and transforming health care." - ()

The push toward “patient-centered” medical care is bearing fruit for Horizon Blue Cross Blue Shield of New Jersey, leading to both lower costs for members and higher scores on so-called quality care metrics.

Those are the findings of a new study released this week by the Newark-based insurer. Along with higher marks in areas such as diabetes control and cancer screenings, the study found that members involved in patient-centered programs get their care at a cost that is 9 percent lower than those at traditional doctor practices.

Patient-centered practices are those in which Horizon works closely with the doctors to better coordinate medical care, reduce unnecessary costs and improve the patient experience. Part of that approach includes rewarding doctors for meeting certain clinical quality, patient satisfaction and efficiency benchmarks, among other features.

Horizon BCBSNJ, the state’s largest health insurer, said it has more than 750,000 members participating in such programs, with more than 6,000 network doctors participating.

“The promise of patient-centered, or value-based, care to deliver better quality care at a lower cost is no longer theoretical, it’s a reality,” Robert A. Marino, chairman and CEO of Horizon BCBSNJ, said in a prepared statement. “The 2014 results further demonstrate how doctors, hospitals and Horizon are innovating and transforming health care to ensure patients receive more coordinated, better quality care at a lower cost.”

For its 2014 results, the insurer reviewed claims data for members receiving care from a patient-centered practice and compared those findings with members receiving care from traditional primary care practices.

In a news release, Horizon said the results found that patient-centered members, as compared with those members in traditional practices, had a:

  • 6 percent higher rate in improved diabetes control.
  • 7 percent higher rate in cholesterol management for diabetic patients.
  • 8 percent higher rate in colorectal cancer screenings.
  • 3 percent higher rate in breast cancer screenings.

The findings also show that more coordinated care is being provided at a lower cost, as Horizon BCBSNJ members in patient-centered practices had a:

  • 8 percent lower rate in hospital admissions.
  • 5 percent lower rate in emergency room visits.
  • 9 percent lower total cost of care.

Unlike the traditional fee-for-service model, patient-centered practices are also financially rewarded to improve patient care based upon national clinical guidelines and also improve the patient experience with steps such as extended hours and more active communication. Patient-centered practices are intended to provide patients with benefits such as a care coordinator who provides additional patient support, information and outreach, along with extra wellness education and active patient monitoring and communication from the doctor and care coordinator.

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Write to the Editorial Department at editorial@njbiz.com

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