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Horizon NJ Health Rates as New Jersey’s Top Medicaid Managed Care Plan

Posted By Admin on March 19, 2012
Tags: Medicaid, Health and Wellness
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Horizon BCBSNJ Company Graded Highest in HMO Performance Report for NJ FamilyCare/Medicaid

Horizon NJ Health, a subsidiary of Horizon Blue Cross Blue Shield of New Jersey, is the highest rated Medicaid managed care plan among all of the state’s participating Medicaid plans. According to the NJ FamilyCare/Medicaid “HMO Performance Report” released last month, Horizon NJ Health received a 92% overall performance score, the highest of all New Jersey’s Medicaid managed care plans and the only plan to improve its overall score from previous reports.

The NJ FamilyCare/Medicaid “HMO Performance Report” for 2010 provides information on the quality of each health plan’s performance that includes the quality of care provided to clients, client satisfaction levels in their health plans and the performance of internal operations of all plans.

“This is great news,” said Karen L. Clark, Vice President Medicaid, Horizon Blue Cross Blue Shield of New Jersey, President, Horizon NJ Health. “The performance report validates our commitment to our members and providers. To be rated as the highest among all of the plans serving New Jersey residents confirms our efforts and the trust our members place in us to consistently deliver quality, accessible care for more than a half a million lives. We are honored and will continue our efforts on behalf of our members.”

The NJ FamilyCare/Medicaid HMO Performance Report uses several quality measures to track member utilization of provider services, health service delivery and client satisfaction with their health plan. The measures used are HEDIS (Healthcare Effectiveness Data and Information Set) which is a set of detailed measures that health plans use to report their overall performance results, CAHPS (Consumer Assessment of Healthcare Providers and Systems Performance Measures), a member satisfaction survey conducted annually by all plans and EQRO, an independent, external quality review organization that conducts reviews of each of the state’s Medicaid health plans to assess quality and compliance standards.

Horizon NJ Health received the best overall compliance score and had the highest ratings in:

  • Childhood Immunizations

  • Well Child visits (includes adolescents)

  • Comprehensive Eye Exams at 72%, well above the national average of 53%

The report also highlights Horizon NJ Health’s 2010 Best Practice/Initiative to reduce the number of emergency visits to the ER by members without dental benefits, as well as those seeking narcotic analgesics. Horizon NJ Health has achieved a 97 percent reduction in member dental ER visits as measured by member visits per thousand members.

The State of New Jersey’s HMO Performance Report can be found at HMO Performance Report

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 services corporation, providing a wide array of medical, dental, and prescription insurance products and services.  Horizon BCBSNJ is an independent licensee of the Blue Cross Blue Shield Association, serving more than 3.6 million members with headquarters in Newark and offices in Wall, Mt. Laurel, and West Trenton.  Learn more at www.HorizonBlue.com

 
About Horizon NJ Health

Horizon NJ Health is New Jersey’s largest managed healthcare organization serving the publicly insured, providing health services for more than 545,000 people in all 21 New Jersey counties. Headquartered in West Trenton, NJ, Horizon NJ Health, a partnership, is a product of Horizon HMO. Horizon HMO is a wholly owned subsidiary of Horizon Blue Cross and Blue Shield of New Jersey. The website for Horizon NJ Health is found at  www.horizonNJhealth.com