Trinitas Regional drops out of OMNIA suit, strikes value-based contract with Horizon

Horizon Blue Cross Blue Shield of New Jersey and Trinitas Regional Medical Center in Elizabeth, N.J., have teamed up to implement a value-based treatment model for patients with congestive heart failure, reports NJ.com.

Advertisement

Trinitas has also agreed to drop out of a lawsuit a group of New Jersey hospitals brought against the insurer last year for excluding the hospitals from its OMNIA network. Some hospitals named in the lawsuit argue Horizon’s decision to rank the facilities in Tier 2 rather than Tier 1 hurts their reputation and their business.

“The concerns we had over OMNIA are offset by the benefits this new collaboration will bring to the greater Elizabeth community,” Trinitas spokesperson Doug Harris said in an official statement.

The Episodes of Care for Heart Failure program will begin this year, according to the report. 

More articles on finance and payer issues: 

Conn. groups ask for removal of Insurance Commissioner over payer mega-mergers
Metamark affiliates with Anthem BCBS of Georgia
Colorado insurers’ proposed premium increases range from 1% to 40%: 10 key findings

 

Advertisement

Next Up in Financial Management

  • Healthcare leaders are often expected to compartmentalize emotion to make difficult decisions, drive results, and maintain operational focus. For many years, I led…

  • Chicago-based CommonSpirit recorded an operating income of $2 million (0% operating margin) in the second quarter of fiscal 2026, down…

  • Amy Assenmacher, RN, senior vice president of revenue cycle at Grand Rapids, Mich.-based Corewell Health, is confident that healthcare is…

Advertisement

Comments are closed.