Value-based hospitals, physicians get 61% of Horizon BCBS’ medical spend

Horizon Blue Cross Blue Shield of New Jersey said 61 percent of what it spends on medical care goes to physicians and hospitals in valued-based agreements.

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The fact that more than half of its payments go to providers that agreed to coordinate care and share savings with the insurer signifies progress in the insurer’s goal to tie more reimbursement to outcomes.

In 2018, Horizon BCBSNJ issued $100.8 million in shared savings to providers. In addition to the payments, BCBSNJ recorded higher clinical outcomes among its valued-based providers when compared to non-value-based practices. Value-based providers were linked with a 6 percent increase in breast cancer screenings and a 4 percent increase in cervical cancer screenings.

To date, more than 4,500 primary care physicians and thousands of other medical professionals partake in Horizon BCBSNJ’s value-based programs. More than 1.7 million members are covered under the programs.

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