Horizon Blue Cross Blue Shield of New Jersey has paid 51 medical practices across the state roughly $3 million in shared savings for achieving quality, cost efficiency and patient satisfaction goals in its 2014 Episodes of Care program.
The EOC program covers 8,000 Horizon patients who received care in five different specialty areas. The full spectrum of care related to a specific procedure, disease diagnosis or health event is managed through the program. Physicians receive fee-for-service payments for the services provided, such as a joint replacement or pregnancy, and are then able to earn additional rewards for achieving quality and cost goals.
"Horizon's EOC program has become one of the fastest growing and most progressive commercial bundled payment programs in the country," Amita Rastogi, MD, CMO of Health Care Incentives Improvement Institute, said in a statement.
Through its EOC program, Horizon specifically managed hip and knee replacements, knee arthroscopies, pregnancies and colonoscopies in 2014. It was able to reduce hospital readmissions for knee arthroscopy by 100 percent, for hip replacement by 37 percent and for knee replacement by 22 percent. It was also able to reduce unnecessary C-sections by 32 percent.
Due to the success of the program, Horizon has added more episodes to its program, including congestive heart failure, hysterectomy, lung cancer, breast cancer and colon cancer.
More articles on accountable care:
River Health ACO drops out of Next Generation program
7 accountable care, shared savings agreements in January
Heritage California ACO to exit Pioneer program