Horizon cutting costs for those who use 'patient-centered' doctors

Small employers struggle to pay rising health insurance bills, year after year — but this year could be different. Horizon Blue Cross Blue Shield of New Jersey is rolling out two new plans that cut premiums 15 percent and waive deductibles if small employers and their workers get their care from Horizon’s network of 3,700 “patient-centered” doctors. Those doctors are working with the state’s largest health insurer to lower costs and keep patients healthy and out of the hospital. 

On July 1, Horizon will launch the two new “Patient-Centered Advantage” plans in the small, under-50-employee market: a bronze version with a $2,500 deductible, and a silver plan with a $2,000 deductible. Horizon said premiums will be 15 percent lower than its current small-group plans. But in addition to that premium discount, the deductible won’t apply if members use Horizon’s patient-centered network: people will just be responsible for co-pays of $40 in the bronze plan and $20 for the silver. 

Small employers and their workers will still have access to the entire Horizon doctor network — they won’t be forced to use patient-centered doctors. But the company hopes that, by waiving the deductible, they can encourage more members to use these innovative practices. 

With 3,700 patient-centered doctors, specialists and other health care professionals in Horizon's networks — and half of its primary care physicians now in its patient-centered model — the insurer has achieved the critical mass to offer a health insurance product built around patient-centered care, according to Christopher M. Lepre, senior vice president of market business units for Horizon. 

Since 2011, Horizon has been expanding its patient-centered network by offering coaching and financial incentives to doctors who agree to work with Horizon to focus on the  quality — rather than the quantity — of the care they deliver. And Horizon said it’s working: In 2012, these practices saw a 23 percent reduction in hospital admissions, 12 percent fewer visits to the ER and a 9 percent lower cost of care for diabetics. 

 “Now we are ready to pass on these savings and these reduced costs to our small group members,” Lepre said.