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Can Connected, Effective Services Make Health Care More Affordable?



State Chooses Horizon Blue Cross Blue Shield of New Jersey Based on its Record of Improving Quality, Customer Experience and Cost—All at the Same Time

By Thomas Vincz, Public Relations Manager

How can the health care system do more while spending less? That’s the $200 million question. Or perhaps, we should say, it’s the answer.

When the State of New Jersey searched for an insurer to provide health care coverage for its nearly 600,000 educators, firefighters, police officers, state and other public employees and retirees under 65, its leadership knew that they had to use their buying power to demand improvements in health care quality, cost and consumer experience. The State issued an innovative RFP that sought to make New Jersey the largest public employer to date to engage high-touch patient-engagement services on a broad scale and sought like-minded partners with a proven commitment to raising the bar and proven results from driving changes that make the health care system better.

Horizon Blue Cross Blue Shield of New Jersey (BCBCNJ) impressed the State by showing how its innovative programs and tools enhance care and convenience while managing costs. Its ability to put its experience to work while saving the State and taxpayers $200 million resulted in Horizon becoming the sole administrator for its two health plans: the State Health Benefits Program (SHBP) and School Employees’ Health Benefits Program (SEHBP). It’s the first time the State has selected a single partner for both plans.

“We are honored that New Jersey continues to put their trust in us to protect the health of the people who teach our children, watch over our families and make New Jersey work,” said Christopher M. Lepre, Executive Vice President of Commercial Business at Horizon BCBSNJ. “We will continue evolving and improving the way we work with patients, physicians and employers to deliver the best possible value. These same innovations can benefit many others beyond State employees.”

Taking a page from New Jersey’s largest employer, here are attributes that can drive value, keep employees healthy and ultimately reduce costs:


Connecting Patients to Care with Less Effort and More Control

It’s often not enough to offer great benefits – employers need to help people understand and access them.

Focusing on navigation and advocacy services that connect patients with care can help reduce barriers and ensure employees get the most out of their insurance plan.

The key is adding value in an easy-to-use and accessible way. In today’s world, that means putting everything at the touch of a button. That’s why Horizon BCBSNJ designed Health Guide, a platform that will offer dedicated one-stop access to customer service, care management and clinical resources. The innovative platform includes both technology and live engagement to help members find resources to address specific health needs. Ultimately, we plan on providing every Horizon BCBSNJ member with this service.

“If you have an abundance of great services and benefits, but they are all in different places and hard to find or use, it can make the patient experience even more difficult to navigate, not less. That’s why we’ve structured our platform to have as much as possible under one roof, including unique features like appointment scheduling and telehealth,” said Lepre. “These new services not only allow us to improve the overall experience for people in the health care system, but also to coordinate an ecosystem of care that is tailored to drive the best possible outcomes for patients.”

Making Care More Effective Through a Human Touch and Health Care Data

What does quality health care mean? It involves care that is personalized, improves the patient experience and most importantly, creates positive outcomes.

To that end, Horizon BCBSNJ has developed advanced collaborations with doctors and hospitals to put the patient at the center of care. These programs have proven to improve care and outcomes while lowering costs.

Those partnerships are also working in tandem with new technology. As physicians and health systems have more access to capture and examine patient data than ever before, there are incredible opportunities to leverage that information to improve medical outcomes.

To take advantage of these new opportunities, Horizon BCBSNJ has launched HealthSphereSM, a data service platform that is specifically designed to provide a 360-degree view of a patient’s health record. Analytics tools, in conjunction with a more meaningful view of a patient’s health record, will allow for early identification of gaps in care, care coordination opportunities and immediate action at the site of care.

Of course, much of what impacts health happens outside the doctor’s office. That’s why we’re connecting members with support and resources in their communities to address transportation, housing, access to healthy food and other social factors through our Horizon Neighbors in Health program. As part of the program, Horizon BCBSNJ care coordinators work with members throughout the state, partnering with both medical providers and social service organizations to get people the resources they need.

Driving Affordability

Better quality care leads to better outcomes, which leads to more savings on current and future care. It’s a virtuous cycle that benefits New Jersey and all employers.

The State will save $200 million a year by adopting the connectedness and effectiveness strategies that Horizon BCBSNJ has developed. We know it’s not enough to estimate savings and hope they materialize. That’s why Horizon BCBSNJ has created accountability for cost measures by setting goals and tracking closely to them to ensure New Jersey is delivering on the value it promises.

Horizon BCBSNJ’s Commitment to NJ

With a discerning lens for superior service, quality products and leading performance standards, the State of New Jersey hand-picked Horizon BCBSNJ as its partner in administering benefits because of its ability to help deliver great care while managing costs.

The privilege to serve employers like the State of New Jersey is positive proof that Horizon BCBSNJ is setting the gold standard for employer health care.