Horizon BCBS: Value-based physician payments up 10%

Horizon Blue Cross Blue Shield of New Jersey reported more than 70 percent of its in-network primary care physicians participated in one or more of its value-based care programs in 2017, up 20 percent over the past two years.

Overall, the health insurer's value-based payments to physicians increased 10 percent to $104 million in 2017. In addition, the insurer said value-based care providers bent the cost curve for consumers. On average, members with providers in value-based payment models saw a 4 percent lower increase in their total cost of care when compared to other members.

Members engaged with value-based providers also saw a 4 percent lower rate in hospital inpatient admissions, a 6 percent higher rate for colorectal cancer screenings and a 7 percent higher rate of breast cancer screenings.

In 2017, providers in Horizon's value-based programs also produced improvements within chronic care management. Under value-based care models, providers yielded a 24 percent lower rate in readmissions for patients with diabetes, a 6 percent lower medical cost trend for patients with congestive heart failure, and a 2 percent reduction in potentially avoidable emergency room visits year over year.

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