Horizon BCBSNJ Metrics Affirm Patient-Centered Model for Improving Care, Lowering Cost

Patient-centered practices are performing better than traditional practices in a number of clinical metrics, including improving diabetes and cholesterol management, according to the results of a study from Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ).

The study of claims data for more than 200,000 Horizon BCBSNJ members in participating patient-centered doctors’ offices compares members in traditional primary care practices with those practices participating in Horizon BCBSNJ’s patient-centered medical home (PCMH) program and found that patient-centered members demonstrated the following outcomes:

  • 14 percent higher rate in improved diabetes control;
  • 12 percent higher rate in cholesterol management;
  • 8 percent higher rate in breast cancer screenings and
  • 6 percent higher rate in colorectal cancer screenings.

The study also shows that more active care is being provided at a lower cost. Key findings among those Horizon BCBSNJ members in patient-centered practices include the following:

  • 4 percent lower rate in emergency room (ER) visits;
  • 2 percent lower rate in hospital admissions;
  • 4 percent lower cost of care for diabetic patients; and
  • 4 percent lower total cost of care.

Members under the care of a patient-centered practice were also able to avoid more than 1,200 ER visits and 260 inpatient hospital admissions, which represent a savings of approximately $4.5 million.

Patient-centered practices provide patients with more coordinated and personalized care, including care coordinators who provide 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, and active coordination of a patient’s care with specialists and other providers.

There are more than 3,700 network doctors in 900-plus patient-centered practice locations in Horizon BCBSNJ’s patient-centered programs. The patient-centered practices include doctors in PCMHs, accountable care organizations (ACOs) and practices focused on episodes of care across New Jersey.

Source: New Models in the Patient-Centered Medical Home: Incentives, Infrastructure and IT to Support Accountable Care

Population Health Framework: 27 Strategies to Drive Engagement, Access & Risk Stratification

New Models in the Patient-Centered Medical Home: Incentives, Infrastructure and IT to Support Accountable Care This 57-page special report offers snapshots of thriving medical home initiatives, including Horizon BCBSNJ’s efforts to engage consumers and health plan members in its medical home program.

This entry was posted in Accountable Care Organizations, Avoidable Hospitalization, Disease Management, Medical Home and tagged , , , . Bookmark the permalink.
  • To receive the latest healthcare business industry news and analysis from the Healthcare Intelligence Network, sign up for the free Healthcare Business Weekly Update by clicking here now
  • Leave a Reply

    Your email address will not be published. Required fields are marked *

    *

    You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

    Cleantalk