Ridgewood NJ, all this talk about Valley Hospital being the “Crown Jewel” of Ridgewood ,but the reality is far different . Valley is according to the new OMNIA Health Alliance at “Tier 2” hospital .
Horizon Blue Cross Blue Shield of New Jersey announced the OMNIA Alliance, a partnership with 22 hospitals which have agreed to accept smaller reimbursements but would be financially rewarded for quality and keeping people healthy. Another 14 hospitals Horizon designated as “tier one” facilities also agreed to accept lower reimbursement in exchange for higher patient volume.
The 14 were ;Chilton Medical Center; Clara Maass Medical Center; Community Medical Center; Hackensack UMC in Hackensack, Mountainside and Pascack Valley; Hunterdon Medical Center; Inspira Medical Center Elmer, Vineland and Woodbury; Jersey City Medical Center; Monmouth Medical Center and its Southern Campus; Morristown Medical Center; Newark Beth Israel Medical Center; Newton Medical Center; Overlook Medical Center, Robert Wood Johnson University Hospital Rahway, Somerset, New Brunswick and Hamilton; Saint Barnabas Medical Center. Hackettstown Medical Center will be added after it is acquired by Atlantic Health
However the remaining 36 hospitals in the state, were left out. The hospitals included in Tier 2 (based on the latest available information) are Bayonne Hospital; Capital Health in Trenton and Hopewell; CentraState Medical Center in Freehold; East Orange General Hospital; Hoboken University Medical Center; Holy Name Hospital; JFK Medical Center, Edison; Kennedy Health System in Cherry Hill, Stratford, and Turnersville; Lourdes Medical Center of Burlington County, Willingboro; Meadowlands Hospital Medical Center, Secaucus; and Memorial Hospital of Salem County.
Also in Horizon’s Tier 2: Our Lady of Lourdes Medical Center, Camden; Raritan Bay Medical Center – Old Bridge and Perth Amboy; Saint Clare’s Hospital in Denville, Dover, and Sussex; Saint Michael’s Medical Center, Newark; Saint Peter’s University Hospital, New Brunswick; St. Francis Medical Center, Trenton; St. Luke’s Warren Hospital; St. Mary’s Hospital, Passaic; Trinitas Hospital, Elizabeth; University Hospital, Newark; Valley Hospital, Ridgewood; Virtua, Berlin, Marlton, Mount Holly, and Voorhees.
Horizon created OMNIA and the tiered network plan in an attempt to curb health insurance costs and provide cheaper options to employers and consumers.
Horizon examined Medicare data and looked for the hospitals with the lowest readmission rates and best scores on patient, safety and quality measures. Hospitals needed to offer a range of inpatient, outpatient and post-acute care services. They had to be using or prepared to use a “value-based” payment model that rewards preventive care. They had to score high on patient satisfaction surveys. Horizon also favored the largest hospitals and systems, including those that serve a sizable number of Horizon members.
Horizon claims they are not passing judgement on the quality of the hospital. Consumers who go to Tier 1 hospitals and doctors pay lower copays and out-of-pocket costs. They can visit hospitals and doctors classified as Tier 2 but pay higher costs when doing so.