The pandemic is beginning to recede, but the federal agency that tracks health spending has issued a report predicting annual price increases averaging 5.1% annually through 2030. The Centers for Medicare and Medicaid Services (CMS) warned consumers to plan for increases for everything from hospital and physician visits to prescription drugs.

Health care prices have been rising steadily for years. Those price increases translate to higher health insurance premiums even for members of not-for-profit insurers like Horizon that spends nearly 90 percent of the premiums it collects paying doctors, hospital, pharmacies and other medical claims.

To offset the anticipated price inflation, Horizon members have choices and tools that give them more control over what they spend on health care.

When doctors, hospitals and insurers work together, members benefit

Premiums and out-of-pocket expenses reflect the underlying cost of health care, and the simple volume of services delivered drives those costs; not the quality of the care patients receive. That’s why health care providers and Horizon are working on innovative care models that replace the traditional fee-for-service arrangement with a model that is driven by quality and a better patient experience.

• In the shared accountability arrangement between Horizon and Atlantic Health System (AHS), both organizations are accountable for the health, quality and total cost of care for 30,000 Horizon members. Started in January 2019, this “risk-sharing” model saw dividends in the first year alone.
• Similar to the AHS agreement, Horizon works with 4,500 physicians in our value-based care arrangements, which reward more affordable costs and agreed-upon quality targets on behalf of our members.
• In Horizon Episodes of Care (EOC) program, one doctor oversees all aspects of care for an episode (a specific medical condition or procedure) rather than just the care that he or she provides. As part of this approach, doctors and insurance companies work together to improve the quality of care to give patients a better health care experience and lower overall costs. The success rate is promising on all counts.

Savings and convenience with prescription drugs

Historically, prescription drugs have been one of the fastest rising health care expenses. In fact, drug costs account for nearly 20 cents of every dollar that Horizon members pay in premiums.

• Here are five ways you can save on prescription drugs, from tools that help you and your doctor reduce your out-of-pocket costs to ordering your meds through Amazon shopping.

Waste, fraud and abuse can drive up premiums; fighting it protects you and your finances

Whether it be identity thieves, computer hackers, or doctors who engage in fraudulent billing, scams drive up the cost of your health coverage. There are several things you can do to stay ahead of scams, and several ways that Horizon is collaborating with government partners to combat fraud and make health care work better for members.

Helping you choose the right care at the right time at the right price

Sometimes it’s hard to know what kind of care you need, and that can make all the difference in costs. Here’s where you can find help.

• Our ER vs. Urgent Care vs. Telemedicine? article helps you decide where to go for the best, most cost-effective care for your illness or injury.

Healing the whole person to improve care and help your wallet

We are not one-dimensional beings—nor should our care treat us as such. Whole-person care is better for people and better for overall costs. Here are 10 ways you may benefit from Horizon’s investments in new programs, partnerships and technologies that deliver an integrated approach to overall health for both body and mind.

Get the most out of your insurance

We want you to take advantage of your health insurance plan to the fullest. That’s why we developed a quick six-step plan overview to help you get the most out of your plan.

Amazon Pharmacy is contracted by Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) to provide pharmacy home delivery services to eligible Horizon BCBSNJ members. Amazon Pharmacy is independent from and not affiliated with Horizon BCBSNJ.