Horizon Blue Cross Blue Shield of New Jersey’s Patient-Centered Pediatric Program

Program Location: 
Newark, NJ
Payer Type: 
Commercial
Payers: 
Horizon BCBSNJ
Description: 

Horizon Blue Cross Blue Shield of New Jersey is transforming and improving New Jersey’s health care delivery system by collaborating and developing solutions to create a health care system marked by high-quality care, a better patient experience and improved affordability.

Horizon Blue Cross Blue Shield of New Jersey’s Patient-Centered Pediatric Program is a family-focused initiative to improve the health of children. This Program was developed in close collaboration with pediatricians, family practice physicians, practice managers and leadership of the New Jersey Chapter, American Academy of Pediatrics. This pediatric/family initiative reinforces the role of pediatricians and family doctors to effectively coordinate all the health care needs of their patients so that children and their families receive the highest quality of care, in the right setting and at the right time. This approach provides personalized and comprehensive care while promoting each family member’s engagement in their own health.

Payment Model: 

Horizon BCBSNJ provides participating practices with the opportunity for potential earnings for developing and updating care plans for their patients with chronic and complex conditions and for demonstrating better quality outcomes and reducing avoidable emergency room visits for their patients. Outcome-based payments are based on achieving specific quality outcomes, like ensuring children receive the appropriate immunizations and the use of appropriate treatment and medications for children with upper respiratory infections and asthma.

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