Horizon NJ Health partnering to improve quality through our Results and Recognition Program

Horizon NJ Health leverages its Results and Recognition (R&R) Program to improve clinical outcomes performance on Healthcare Effectiveness Data and Information Set (HEDIS) measures and improve the care our members receive. HEDIS reports on how well a health plan is improving the health of its members. Since the inception of the R&R Program, Horizon NJ Health HEDIS performance has improved.

The R&R program provides a variety of opportunities that lead to better care and improved health outcomes for members. Through collaboration with Horizon NJ Health, the program offers financial incentives to providers for improved performance for specific HEDIS measures. In the R&R Program, providers are educated on best practices for preventive screenings, immunizations and treatment of chronic conditions, as well as how to optimize the data capture that reflects quality improvement outcomes. A designated Clinical Quality Improvement Liaison (CQIL) assists providers with clinical practice transformation by providing detailed reports identifying gaps in care and ensuring compliance with HEDIS coding guidelines.

The primary goal of the R&R Program is to improve the health and quality of care received by our members. Improvements in HEDIS performance reflect the value proposition of the R&R Program and its ability to enhance the member experience and promote better care.

R&R Program structure:

As part of the R&R Program, we offer providers:

• Incentive payments

• Monthly quality report cards and patient level detail gap reports

• Support and education for you and your staff on quality improvement and report analysis

• Three payments per year and a detailed payment report

We are excited to work with you to provide the highest quality of care to our members.

For questions about the R&R Program, please contact the Horizon Healthy Journey team at 1-844-754-2451, Monday through Friday, from 8:30 a.m. to 5 p.m., Eastern Time.