Horizon Blue Cross Blue Shield of New Jersey and Meridian Health Enter into an Accountable Care Organization Agreement
Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) and Meridian Health announced a collaborative Accountable Care Organization (ACO) agreement for its new OMNIA health plan members through Meridian Health Partners, Meridian’s clinically integrated network. Horizon BCBSNJ members who enroll in an OMNIA plan would enjoy lower premiums, and if their care is delivered by the ACO’s doctors and ancillary providers -- which are Tier 1 for OMNIA health plan members – they will also save on out of pocket costs. The ACO includes doctors who are part of Meridian Health Partners, doctors at Meridian hospitals, and affiliated ancillary providers and independent physicians throughout Monmouth and Ocean counties.
“This patient-centered ACO with Meridian Health is in keeping with Horizon’s efforts to transform New Jersey’s health care system, with a focus on delivering better patient care, an enhanced patient experience, and lower total costs,” said Allen Karp, senior vice president of Healthcare Management for Horizon BCBSNJ.
“The health and well-being of our community has always been our number one priority,” says Patrick Young, executive vice president of Meridian Health Solutions. “As we continue to focus on affordable, high-quality health care, our collaboration with Horizon and this ACO agreement, through Meridian Health Partners, will allow us to promote better clinical integration and patient experience for its OMNIA health plan members.”
ACOs are built on a primary care foundation with an emphasis on preventive care that keeps patients well. Participating physician groups help create a healthier patient population through a coordinated and more active approach to patient care among providers within the ACO. ACOs are designed to increase accountability to achieve improved quality outcomes for patients and decrease unnecessary and duplicative medical tests and treatments.
Under the ACO agreement with Meridian Health Partners, Horizon BCBSNJ will provide care coordination payments to Meridian Health Partners to take on additional accountability for its OMNIA health plan members by improving the health and patient experience as well as controlling the total cost of care. Meridian Health Partners and its physicians will have an opportunity to share in the resulting financial savings with Horizon BCBSNJ, provided they meet certain clinical quality, patient satisfaction, and cost savings measures.
Patient-centered practices, including ACO’s, 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.
There are more than 6,000 network doctors and greater than 750,000 members participating in in Horizon BCBSNJ’s patient-centered programs. The patient-centered practices include doctors in Patient-Centered Medical Homes (PCMHs), ACOs and practices focused on Episodes of Care across New Jersey.
For 2016, the majority of the providers participating in Horizon BCBSNJ patient-centered programs, such as Patient Center Medical Homes and ACOs, including this collaborative with Meridian Health and the physicians of Meridian Health Partners, are designated as OMNIA Tier 1 under the new OMNIA health plans. The OMNIA health plans are being offered to employers and individual consumers beginning January 1, 2016.
About Horizon Blue Cross Blue Shield of New Jersey
Horizon Blue Cross Blue Shield of New Jersey, the state’s oldest and largest health insurer is a tax-paying, not-for-profit health service corporation, providing a wide array of medical, dental, and prescription insurance products and services. Horizon BCBSNJ is leading the transformation of health care in New Jersey by working with doctors and hospitals to deliver innovative, patient-centered programs that reward the quality, not quantity, of care patients receive. Learn more at www.HorizonBlue.com. Horizon BCBSNJ is an independent licensee of the Blue Cross and Blue Shield Association serving more than 3.8 million members.
About Meridian Health
A leading not-for-profit health care organization in New Jersey, comprising Jersey Shore University Medical Center and K. Hovnanian Children’s Hospital in Neptune, Ocean Medical Center in Brick, Riverview Medical Center in Red Bank, Southern Ocean Medical Center in Manahawkin, Bayshore Community Hospital in Holmdel, and Meridian Partner Companies that include home health services, skilled nursing and rehabilitation centers, ambulatory care, ambulance services, fitness and wellness centers, and outpatient centers. In April, Meridian Health and Raritan Bay Medical Center signed a definitive agreement to merge. In May, Meridian Health and Hackensack University Health Network also signed a definitive agreement to merge. Meridian Health has consistently been rated among the top performing health systems in New Jersey for clinical quality, is one of the FORTUNE “100 Best Companies to Work For” for six consecutive years, and is the recipient of numerous state and national recognitions for patient care and nursing excellence. Meridian Health is a member of AllSpire Health Partners, an interstate consortium alongside six of the nation’s leading health systems, to focus on the sharing of best practices in clinical care and achieving efficiencies. With more than 100 convenient locations, over 1,800 beds, nearly 13,000 team members, and affiliations with more than 2,000 of the area’s finest physicians, Meridian Health is a leading health care provider in New Jersey, providing quality health services, facilities, and programs. For more information, please visit www.MeridianHealth.com.