10:48 AM

Horizon Blue Cross Blue Shield of New Jersey announces a new and innovative episode of care program for Crohn’s disease

Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) announced today that it has embarked on a new groundbreaking, value-based Episode of Care program that will incorporate a mental health assessment and treatment component into the treatment plans of members who have Crohn's disease. Horizon BCBSNJ is partnering on the Crohn's disease episode with Digestive HealthCare Center. Horizon BCBSNJ collaborated with Digestive HealthCare Center in 2014 to establish New Jersey's first colonoscopy episode of care program.

"Horizon continues to break new ground in our collaborations with doctors, hospitals and specialists who share our commitment to transform New Jersey's healthcare delivery system to be more patient-centered and value based,” said Horizon BCBSNJ Episodes of Care Director, Lili Brillstein.

Brillstein noted that patients with chronic diseases like Crohn's can experience behavioral health symptoms which can adversely impact their physical wellbeing and medical treatment. "Bringing a behavioral health component into this episode can help us understand how to improve care for the whole person, which can ultimately enhance the patient experience, improve patient outcomes, and reduce costs," Brillstein added.

Through this episode, Digestive HealthCare will collaborate with professionals in Horizon BCBSNJ's behavioral health network who are experienced in working with patients with Crohn's and other chronic GI conditions. The goal of the one-year episode is to identify Crohn's patients who may benefit from behavioral health support and ensure that they receive those services. That support can prove essential to optimizing the benefits of their medical care by increasing the likelihood that patients adhere to their treatment plans, better manage their disease and avoid unneeded emergency room visits and hospital admissions.

"This new episode will allow us to take a fully integrated approach to Crohn's disease, with the goal of achieving the best possible outcomes for patients by bringing behavioral and medical treatments into harmony," said Dr. Charles Accurso of Digestive HealthCare Center. "Through innovation, we can transform health care delivery, and collaboration with payers like Horizon makes this innovation possible."

The Crohn's episode is a pilot and will initially include about 50 Horizon BCBSNJ members and will be conducted by Digestive Health's seven physicians at three office locations in Hillsborough, Somerville and Warren.

Horizon BCBSNJ's behavioral health administrator, Beacon Health Options, worked to identify the behavioral health practitioners that will be working with Digestive HealthCare in the new episode.

"Beacon believes this episode can help to improve the quality of life for Horizon members, as well as help bring behavioral health into the mainstream of therapies for the effective treatment of chronic medical conditions," said Ann O'Grady, LCSW, assistant vice president of Clinical Services for Beacon Health Options.

Physicians participating in Horizon BCBSNJ's episode of care programs communicate and collaborate across the full spectrum of to ensure that patients' experience is streamlined and optimized. If the participating doctors meet quality and efficiency goals, they may be eligible to share in the resulting savings.

Horizon BCBSNJ has a number of patient-centered programs, including Accountable Care Organizations, Patient-Centered Medical Homes, and programs focused on different Episodes of Care (i.e. joint replacement, pregnancy). More than one million Horizon BCBSNJ members are now benefiting from Horizon BCBSNJ's patient-centered programs that are working to improve patient care while controlling costs.

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.