Horizon Blue Cross Blue Shield of New Jersey and Holy Name Medical Center Launch Accountable Care Organization

On Apr 8, 2014

Newark-based Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) and Teaneck-based Holy Name Medical Center, through its HNMC Hospital/Physicians ACO, form a new Accountable Care Organization (ACO) designed to improve patient care coordination and quality outcomes for over 3,000 Horizon BCBSNJ members. The new ACO will serve Horizon BCBSNJ patients being treated by more than 80 doctors practicing at approximately 22 office locations.

“We look forward to working with Holy Name and their doctors as we continue to transform New Jersey’s health care delivery system to reward the value of care patients receive, not the volume of care,” said Jim Albano, Vice President of Network Management and Horizon Healthcare Innovations at Horizon BCBSNJ.

“This collaborative Accountable Care Organization with Horizon is designed to support strong patient care coordination to help deliver better quality outcomes and improve the overall health care experience for our patients,” said Michael Maron, President and Chief Executive Officer of Holy Name Medical Center.

Built on a primary care foundation, the ACO is a model of care where participating physician groups work collectively to create a healthier patient population through a coordinated approach to care. ACOs are designed to increase cooperation, communication, and accountability to achieve measured patient quality outcomes and decrease unnecessary and duplicative medical tests and treatments.

Under this ACO agreement, Horizon BCBSNJ will provide care coordination payments to the ACO to take on additional accountability for improving the health and patient experience as well as controlling the cost of care for its Horizon BCBSNJ patients. The ACO and its affiliated practices — provided the ACO meets certain health improvement, patient satisfaction and cost goals — have an opportunity to share in the resulting financial savings with Horizon BCBSNJ.

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 500,000 Horizon BCBSNJ members are now benefiting from these programs that are working to improve patient care while controlling costs.