SEPTEMBER 9, 2015 LAST UPDATED: THURSDAY, SEPTEMBER 10, 2015, 12:03 AM
BY LINDY WASHBURN
STAFF WRITER |
THE RECORD
After years of managed-care wars between health care providers and insurance companies, New Jersey’s largest insurer is to announce Thursday an alliance with six hospital systems and the state’s largest physician group to get these erstwhile competitors on the same side. The plan is to work together to coordinate patient care, lower costs and use financial incentives to steer patients to its 22 member hospitals and affiliated doctors.
Horizon Blue Cross Blue Shield of New Jersey will offer insurance plans for 2016 that will encourage members to use a select group of “Tier One” hospitals by offering a financial incentive — waiving the deductible and the coinsurance for some of the care they receive.
Members will still be able to use Horizon’s broader network — which includes all but three of the state’s hospitals and about 80 percent of its physicians — but will pay more in out-of-pocket expenses to do so. Patients who go to hospitals in other states will also pay more in out-of-pocket costs.
Details of the premiums and cost sharing are to be announced in October when the plans go on the market, a Horizon spokesman said.
They will not be available to Medicaid or Medicare patients but will be included as an option for state employees. Dudley Burdge, senior staff representative for the Communications Workers of America union local representing state workers, expects that premiums “will be 25 percent less than the most popular plan for state employees.”
The Tier One hospitals in Bergen County will be Hackensack University Medical Center, HackensackUMC North at Pascack Valley in Westwood and Englewood Hospital Medical Center — all part of the Hackensack University Health Network, one of the six health systems to join the newly formed Omnia Health Alliance.
