Horizon's Early Results Show Patient-Centered Medical Homes Drive Quality and Cost Improvements

Horizon Blue Cross Blue Shield of New Jersey announced “ground-breaking” results from its statewide PCMH program.  Collaborating with leading primary care doctors and the New Jersey Academy of Family Physicians, BCBSNJ developed the PCMH program with the goal of increasing accountability and improving coordination and quality of patient care.  Preliminary quality and cost trends from 2011 indicate that this program reached its goals of improving quality while at the same time reducing health care costs.  Patients within the medical home had an 8% higher rate in improved diabetes control as measured through HbA1c as well as 6% higher rates for both breast and cervical cancer screenings.  Indicators of cost and utilization showed a decrease by 10% in PMPM costs, 26% lower ER visits, 25% lower hospital readmissions, 21% lower inpatient admissions, and 5% higher rate in use of generic prescriptions. Horizon BCBSNJ has expanded this program to include more than 80,000 members with plans to continue expansion through 2012. Currently, 152 physicians from 22 practices within 10 counties participate in the PCMH program.