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The New Normal: How Value-Based Care Is Reaching More Patients at One Insurer

While Congress has spent much of the year debating the fate of “Obamacare,” healthcare transformation continues among payers and in practices. The quest for “patient-centered” care—which focuses on prevention, involves patients in decisions, and rewards physicians for keeping people healthy instead of paying them for every test or procedure—is far from over. But signs abound that no matter what happens in Washington, we’re past the point of no return.

Such was the case in New Jersey this week when the state’s largest insurer, Horizon Blue Cross Blue Shield, shared 2016 results for its top-performing patient-centered programs, which include those participating in the OMNIA Alliance. Horizon announced that 1.5 million of its 3.8 million members are participating in patient-centered programs. That share is up 50% from the prior year, to 39.4%. The share of primary care physicians grew 10%, and payments increased 43%, to $100 million, from 2015.
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