Horizon Blue Cross Blue Shield of New Jersey Re-Unites with CMS to Help More Primary Care Doctors Improve Patient Care

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Horizon chosen by CMS for CPC+ program to improve primary care delivery

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Through CPC and our own value-based efforts, Horizon has made tens of millions of dollars in value-based payments and other investments over the last six years to give primary care doctors and their care teams the tools to transform their practices.

For the second time in four years, Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) has been chosen to participate in a multi-payer initiative from the Centers for Medicare & Medicaid Services (CMS) to help primary care doctors transform their practices to better meet the needs of their patients and improve care. CMS today announced the creation of Comprehensive Primary Care Plus (CPC+), a program in which insurers in 14 selected markets – including New Jersey -- will collaborate with participating primary care doctors on new payment models that reward practices for achieving better care, smarter spending and healthier patient outcomes. The CPC+ markets were selected based on the locations of the payers that applied.

“CPC+ is a another bold commitment from CMS to accelerate the transition to a health care delivery system that rewards doctors when they achieve improved quality outcomes that keep their patients well while better controlling costs,” said Allen Karp, senior vice president, Healthcare Management for Horizon BCBSNJ. Karp noted that New Jersey and Horizon were also chosen by CMS in 2012 for a smaller, four-year, CPC initiative with the identical goal of helping primary care practices transform to a value-based care model. The current CPC program, which includes seven regions, ends in December of this year, while CPC+ begins in January, 2017.

“Through CPC and our own value-based efforts, Horizon has made tens of millions of dollars in value-based payments and other investments over the last six years to give primary care doctors and their care teams the tools to transform their practices. CPC+ will help infuse millions more in payer dollars so that additional practices can bring this improved care delivery approach to their patients,” Karp said.

Through an applications process, CMS will choose primary care practices throughout New Jersey to participate in CPC+. CMS will pay participating practices a monthly care management fee for their attributed Medicare fee-for-service beneficiaries as well as a performance-based incentive payments that focus on quality and utilization measures which reduce beneficiaries total cost of care.

CMS is soliciting applications from eligible practices within the 14 regions from August 1-September 15. New Jersey practices can obtain additional information and apply by visiting http://innovation.cms.gov/initiatives/Comprehensive-Primary-Care-Plus or emailing CPCplus(at)cms(dot)hhs(dot)gov.

Under health plan participation in this initiative, all participating practices will have the opportunity to contract directly with health plans participating in CPC+. For example, practices selected for this initiative will have the opportunity to participate in Horizon BCBSNJ’s patient-centered programs, which provide financial support and other transformation resources to help doctors deliver more effective and efficient care.

There are more than one million Horizon BCBSNJ members participating in the company’s patient-centered programs.

About Horizon Blue Cross Blue Shield of New Jersey
Horizon Blue Cross Blue Shield of New Jersey, the state’s oldest and largest health insurer is a tax-paying, not-for-profit health service corporation, providing a wide array of medical, dental, and prescription insurance products and services. Horizon BCBSNJ is leading the transformation of health care in New Jersey by working with doctors and hospitals to deliver innovative, patient-centered programs that reward the quality, not quantity, of care patients receive. Learn more at http://www.HorizonBlue.com. Horizon BCBSNJ is an independent licensee of the Blue Cross and Blue Shield Association serving more than 3.8 million members.

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Thomas Vincz
Horizon Blue Cross Blue Shield of New Jersey
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