In 2019, all of us at Horizon Blue Cross Blue Shield of New Jersey were focused on a singular goal: to empower our members to achieve their best health.
Those words come straight from our Mission Statement, and they have served as the galvanizing force behind all of the actions we took last year to make health care work the way our members want and deserve.
In a fast-changing industry such as ours, however, turning the words of our Mission Statement into actions requires navigating a continuously shifting landscape.
Health care is becoming increasingly digital, so last year we doubled down on technology. With our secure member portal and award-winning Horizon Blue app, members can now download plan details, schedule an appointment, make a payment and even access care via video or chat with a nurse or board-certified physician. We also used real-time data analytics to help identify members who might benefit from support to ensure they take the medications they need. In addition, we employed new online tools to help physicians prescribe the most cost-effective medications for their patients.
Health care is also increasingly collaborative. We have:
- started a research partnership with Rutgers University to improve health care delivery in more than a dozen areas of care;
- established a Clinical Advisory Council of Nurses and Social Workers to tap their deep knowledge of patient care; and
- expanded our Episodes of Care program, a collaborative effort in which doctors oversee all aspects of a patient’s treatment with the goal of improving quality and the patient experience while also lowering costs.
A similar goal underpins our OMNIA Health initiative, a multiyear collaboration with health care professionals and organizations across the state to foster more value-based care. OMNIA Health Plan enrollment in 2019 exceeded 450,000, surpassing our targets once again and providing our members with a high-quality, lower-cost care option.
Our commitment to collaboration continues in 2020 with the recently announced partnership with 17 other Blue Plans, the Blue Cross and Blue Shield Association and non-profit Civica Rx to lower the cost of generic medications for our members. Nationally, the program is expected to generate hundreds of millions of dollars in savings, which will be passed along to consumers.
annual physical exams
Finally, health care in 2019 became more integrated — focused on the whole person and taking into account all the factors that can influence health. Last year we launched a first-of-its-kind pilot program in which we provide coordinated care for members with both behavioral and physical health issues. And, we expanded our Horizon Neighbors in Health initiative in Newark, a pioneering program that seeks to improve care for some of our neediest members by addressing the social determinants of health.
On another front, The Horizon Foundation for New Jersey continued its important work in 2019. A cornerstone of New Jersey charitable giving, The Horizon Foundation has funded efforts to bring dental services to underserved children, expand health navigation programs in the Hispanic community, and address childhood obesity. It also continued to combat the opioid epidemic by collaborating with the Partnership for a Drug-Free New Jersey, the federal Drug Enforcement Administration and others in a three-pronged effort of education and prevention, treatment and recovery, and community outreach.
in grants since 2004
All of these actions are about helping our members achieve their best health. We feel this commitment deeply because we are New Jersey’s largest and most experienced health insurer. Our 3.5 million members, our 5,500 employees and the thousands of health care professionals we work with every day are our neighbors and friends.
That is why we are especially proud to have submitted the winning bid to provide health insurance for the nearly 600,000 public employees covered by the New Jersey State Health Benefits Program/School Employees’ Health Benefits Program. As part of that plan, we are committed to lowering total costs while also improving the quality and experience of care delivered to our state’s hard-working public employees.
While 2019 was about turning the inspiring words of our Mission Statement into concrete actions, we know that there is much more that we could and should be doing to help our members. To do so, however, we need to shed certain limitations on how we can invest and innovate. Those limitations were put in place decades ago — long before the dramatic changes in health care were even contemplated.
We are now seeking legislation that would allow us to change our corporate form to a not-for-profit mutual — a form already adopted by Blue Cross Blue Shield plans in 18 other states. Adopting this new form would not change our not-for-profit status or alter our member-focused Mission. However, it would allow us to modernize the way we do business — to invest in new consumer-friendly technologies, pursue collaborations to expand value-based care, and create new integrated care models that address behavioral health issues as well as social determinants of health.
As we announced earlier this year, on April 6th I assumed the role of Executive Chairman of the Board in order to spend more time focusing on the very substantial transformational changes Horizon BCBSNJ is, and will be, making. At the same time, we augmented our senior team by naming Gary St. Hilaire as our new President and CEO. Gary was formerly the CEO of Capital Blue Cross, in Pennsylvania, for eight years and brings a wealth of experience in refining strategy, aligning its implementation across a company, and directing all aspects of operations. We are both committed to building on Horizon BCBSNJ’s contributions to the communities across New Jersey that we serve.
We have all seen the profound impact of the coronavirus (COVID-19) in our state, our nation and around the world. At Horizon BCBSNJ, we moved quickly to ensure the safety and well-being of our 5,500 employees, our 3.5 million members, and the thousands of health care professionals caring for the sick. Among some of the actions we took to help our members were:
- eliminating member out-of-pocket costs for in-network telemedicine services for any covered service;
- eliminating member out-of-pocket costs for COVID-19 testing, evaluation and in-network, inpatient treatment;
- waiving the “actively at work” requirement for group policies to enable employers to maintain coverage for employees who are furloughed, temporarily laid off, or whose hours have been dramatically reduced;
- creating an online resource dedicated to COVID-19, which is available in both English and Spanish, to help keep customers informed of the latest Company news and provide answers to key coverage questions and links to credible external COVID-19 information sources.
And because we have a deep respect and appreciation for our health care professionals on the front lines of this pandemic, we were proud to commit $2.35 million to donate 500,000 N95 respirator masks and 81,000 face shields to Governor Murphy’s coordinated response effort. This is the largest single donation made by our Company in its 88-year history. We also donated $2 million to The New Jersey Pandemic Relief Fund. The Fund is focused on directing money and resources to those in our state with the greatest needs due to COVID-19, and was established by Tammy Murphy, the First Lady of New Jersey and Founding Chair of the Fund. Additional donations of $100,000 to the Community Food Bank of New Jersey and $60,000 to the Jewish Family Service of Atlantic and Cape May are helping these organizations respond to the needs of New Jerseyans feeling the economic impact of the pandemic.
We are proud to be in our 88th year of service to the residents of New Jersey. As we prepare for the next 88 years and continue to fulfill our mission, we are focused on the need to keep pace with the rapidly changing world in which we now operate. Thank you for entrusting us with your health and well-being and know that each and every one of us at Horizon BCBSNJ is committed to empowering you to achieve your best health.