Horizon BCBSNJ timeline - Year Company Milestone
First Hospital Service Plan was organized as the Associated Hospitals of Essex County, Inc.
The Plan went statewide as Hospital Service Plan of New Jersey (HSP).
The Enabling Act providing for the organization of non-profit medical service corporations was passed by the Legislature and signed into law in May.
The Medical-Surgical Plan of New Jersey was incorporated.
Legislation was passed setting up the State Employees' Health Benefits Commission empowered to purchase basic health insurance from Blue Cross and Blue Shield.
Legislation was enacted permitting participation by New Jersey Blue Cross and Blue Shield in national accounts, joint Blue Cross Blue Shield subscriber contracts, and master group contracts.
Medicare went into effect July 1, with more than 80 of about 120 hospitals in New Jersey electing Blue Cross to administer their claims under Part A. Blue Cross and Blue Shield put Complementary coverage on the market, to fill in the gaps under Medicare.
HSP went on the market with a freestanding benefit for prescribed drugs, with participating pharmacists accepting the Plan's fee for preparation plus cost of materials.
New Jersey's Medicaid bill was enacted and amended to preserve a role for Blue Cross in the administration of this new benefits program for welfare categories.
The marketing of Major Medical benefits to local experience-rated groups (LERs) was approved by the Commissioner. Coordination of Benefits (COB) with other carriers for group subscribers was instituted to reduce duplicate payments.
New Jersey's first Health Maintenance Organization (HMO) opened in July in Trenton under HSP sponsorship, in cooperation with Mercer Regional Medical Center. Marketing of this new HMO product, labeled "Medigroup", subsequently was broadened to Vineland and a physicians' group serving Cumberland and Salem Counties.
Blue Cross and Blue Shield announced year-round "Open Enrollment", subject to a one-year, pre-existing exclusion and automatic transfer of applicants with impaired health into a co-pay program known as "Co-Op" coverage. Blue Shield was empowered to underwrite Dental coverage.
Major Medical made available to individual subscribers, regardless of health history.
New subsidiary, Medigroup, Inc., formed to develop a statewide network of affiliated HMOs.
Pre-admission Review (PAR) cost containment program begun to help identify procedures for which inpatient admission is not necessary. Other cost containment programs, Mandatory Second Surgical Opinion Program (MSSOP) and Incentive Ambulatory Surgery Program (IASP) made generally available to groups of 50+. Development of Managed Care program begun to coordinate cost containment activities.
Hospital Service Plan of New Jersey, Inc. (Blue Cross of New Jersey) and Medical-Surgical Plan of New Jersey, Inc. (Blue Shield of New Jersey) merged to become Blue Cross and Blue Shield of New Jersey, Inc.
The Plan took a leading role in creating the New Jersey Cesarean Section Task Force, putting its extensive data on providers, treatments and costs to strategic use to examine why New Jersey's rate of cesarean births is one of the nation's highest.
The Plan began implementation of its sophisticated "single stream" claims processing system.
Landmark legislation ensured consumer access to health care coverage by spreading the risk for the individual market among all carriers who underwrite health insurance in New Jersey, effectively ending BCBSNJ's role as the state's insurer of last resort. BCBSNJ strengthened its position in the managed care market with initiatives to create a more cost-effective hospital network and enhance technological support.
BCBSNJ implemented a strategic decision to expand its managed care operations, creating managed care hospital and dental networks and developing a new portfolio of managed care programs. In addition, the Plan entered the Medicaid HMO market.
Managed care growth continued: membership in managed care programs rose to 25 percent of total membership.
As the result of a competitive bidding process, BCBSNJ retained its role as administrator of the hospital portion of the State of New Jersey's indemnity plan, while regaining the medical/surgical and major medical portions of the State Health Benefits Program. BCBSNJ was also awarded the State's New Jersey Plus program. These changes were effective January 1, 1996, and resulted in the addition of 500 new jobs and an increase of 103,000 members to BCBSNJ's managed care rolls.
The Plan entered the Medicare HMO market. Near the end of the year, BCBSNJ agreed to sell its family health centers to the company that had overseen their construction and managed them.
BCBSNJ abandoned previously announced plans to acquire the business of Blue Cross Blue Shield of Delaware and to convert to a mutual insurance company and merge with Anthem Insurance Companies, principally as a result of regulatory delays and related litigation. Efforts to expand the company's regional presence were refocused on the creation and licensing of HMO and insurance company subsidiaries in surrounding states.
The company began doing business as Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) and its operating subsidiaries adopted similar names. Horizon BCBSNJ's membership exceeded 2 million in New Jersey. Pennsylvania and New York health insurance and Delaware HMO and health insurance subsidiaries were licensed.
Horizon BCBSNJ announced a corporate realignment and implemented initiatives for the company to achieve world class status. Horizon Healthcare of New York was licensed to operate as an HMO in New York City and surrounding counties. Horizon Mercy pursued acquisitions that make it the largest provider of Medicaid HMO services in New Jersey and one of the largest providers in the United States.
Horizon BCBSNJ explored options to strengthen its presence, grow its businesses and emphasize its renewed commitment to South Jersey, while scaling back Pennsylvania and Delaware operations.2001Legislation adopted establishing a process that would allow Horizon BCBSNJ to convert from its current status as a not-for-profit health service corporation to a "for-profit" domestic stock company.
Horizon BCBSNJ introduced the World Class Clinical Quality health care initiative in an effort to improve the overall health of residents in the region by providing access to care, making information available to providers and consumers and promoting evidence-based medicine through effective preventive health and disease management programs.
The company's Health Care Dollars & Sense campaign, a multiyear, multimedia initiative, was launched to provide education to the public on the nature of the crisis in rising health care costs and its impact on all health care constituents. The company established and provided substantial initial funding for The Horizon Foundation for New Jersey, a charitable organization dedicated to promoting health, well-being and quality of life in New Jersey's communities.
Horizon BCBSNJ continued to solidify its position as New Jersey's largest health insurer and a premier regional health care company, with projected year-end enrollment in excess of 3 million members and nearly $1 billion of accumulated surplus. Over 1 million dental members enrolled as of September 30, 2004.
Horizon BCBSNJ decided not to pursue a conversion of the company to a for-profit corporation. During 2005, enrollment grew by 106,000 members, raising the company's total to over 3.2 million members. At the same time, the company retained over 97 percent of its members, which was the second highest retention percentage of all Blue Cross and Blue Shield Plans with similar levels of local market share. In addition, Horizon BCBSNJ made a major commitment to the Medicare Part D program, building the necessary infrastructure to support the program and taking a leadership role in helping seniors understand their health care choices. When the program went live in January 2006, Horizon BCBSNJ covered over 132,000 seniors.
In August 2006, Horizon BCBSNJ made a strategic business decision to withdraw its health insurance products in New York. Horizon Healthcare Insurance Company of New York members were to be transitioned to other carriers by February 28, 2007. The company continued to sell its dental plans in New York. The Horizon Foundation for New Jersey made its largest grant to date, the five-year, $5 million grant initiative will support health centers throughout New Jersey that provide health care to uninsured and underserved populations.
Horizon BCBSNJ awarded $6 million in payments to 60 network hospitals as recognition for high quality and patient safety measures in the company's inaugural year of its Hospital Recognition Program. The Hospital Recognition Program is a collaboration between Horizon BCBSNJ and the Leapfrog Group and is focused on encouraging improved quality of care in New Jersey hospitals. The National Committee for Quality Assurance (NCQA) upgraded Horizon BCBSNJ's HMO accreditation to "Excellent with Distinction" for its early adoption of the Physician and Hospital Quality Plus Program that provides members with important information about physicians and hospitals in the Horizon BCBSNJ network.
Horizon BCBSNJ invests in a first-in-the-nation, ground breaking pilot program demonstrating the effectiveness of the Patient Centered Medical Home concept of care. Focusing on members with diabetes, the pilot program gives incentives to primary care physicians to partner more closely with their patients. As a result of the program, patients dramatically increased adherence to their prescribed medical protocols, improving member health and lowering health care costs. Horizon BCBSNJ announces it is exploring the possibility of converting to a for-profit company.
- Horizon BCBSNJ maintained its Standard & Poor's "A-" rating with revenues of $8.2 billion and reserves of $1.73 billion.
- Horizon NJ Health, once again, received the highest score among the state's Medicaid HMO plans, as highlighted in the New Jersey Division of Medical Assistance and Health Services’ 2009 Annual Assessment of HMOs. In a review of more than 200 elements for quality, Horizon NJ Health demonstrated best practices in several areas including its Health Care Literacy Program.
- Medicaid Health Plans of America recognized six Horizon NJ Health programs in its '2009-2010 Best Practices Compendium.'
- Horizon BCBSNJ was recognized as one of The Nation's 100 Best Companies by Working Mother Magazine.
- Horizon BCBSNJ was ranked in the top 500 Information Technology companies in the 2010 Information Week 500.
- Diversity MBA Magazine ranked Horizon BCBSN #11 in the nation as "Best Place For Diverse Managers."
- Horizon BCBSNJ was the only health plan in New Jersey to administer the NJ Protect Plan for uninsured residents with pre-existing conditions.
- On November, 29, 2010, William J. Marino announced his retirement, effective March 1, 2011, after 17 years as CEO.
- In January, Horizon Healthcare Innovations, LLC (HHI), a wholly-owned subsidiary of Horizon Blue Cross Blue Shield of New Jersey and 63 primary care physicians, serving 24,000 Horizon BCBSNJ members, announced the launch of New Jersey’s first comprehensive, state-wide Patient Centered Medical Home (PCMH).
- Robert A. Marino became President and CEO, effective March 1, 2011. Mr. Marino, with 38 years of experience in the Blue Cross Blue Shield system and 20 years with the company, had served as Executive Vice President and Chief Operating Officer since 2008.
- In October, Horizon BCBSNJ created a blog – "Health Insurance Illuminated," to promote a better understanding of health insurance issues among members and the public at large.
- Horizon rolls out the Blue to You van – a state-of-the art mobile unit delivering personalized customer service and community support for Medicare-eligible members and the public in Ocean County.
- In January, Horizon Blue Cross Blue Shield of New Jersey is recognized as one "The Best Insurance Companies in 2012," according to Insure.com.
- In February, 2012, Horizon Healthcare Innovations, a subsidiary of Horizon Blue Cross Blue Shield of New Jersey, along with Duke University School of Nursing and Rutgers College of Nursing, announced a collaborative partnership to train at least 200 nurses over the next two years to be Population Care Coordinators throughout primary care practices in New Jersey.
- On February 6, 2012, The Horizon Foundation for New Jersey launched Phase 2 of its Health Center Initiative to support 501(c)(3) nonprofit Federally Qualified Health Centers free/volunteer clinics and independent clinics in New Jersey that expand access to health care for the state's uninsured and underserved residents.
- Horizon Blue Cross Blue Shield of New Jersey’s Board of Directors on March 9, 2012 elected President and CEO Robert A. Marino as its new Chairman, succeeding Emmanuel A. Kampouris, who retired after thirteen years of service on the Board.
- In January, 2013 Horizon BCBSNJ announced the awarding of the company’s behavioral health services contract, effective January 2014, to ValueOptions Inc., the nation’s largest independent behavioral health care and wellness company, replacing Magellan Behavioral Health, Inc.
- In February, Horizon BCBSNJ announced that the "Blue to You" program - a mobile outreach initiative for Medicare-eligible members and consumers in Ocean County - has been expanded to Monmouth County.
- In April, Standard & Poor's upgraded Horizon BCBSNJ's financial rating from "A-" to "A." The ratings agency noted Horizon BCBSNJ's "strong business profile and very strong financial profile."
- In April, Horizon BCBSNJ announced a new mobile app, making it faster and easier for members to access their health information, find providers and manage claims on mobile devices.
- In May, Horizon BCBSNJ announced the creation of its first private exchange, HorizonSelect, an online private marketplace for commercial group employers with more than 50 employees.
- Horizon BCBSNJ continued to expand its Patient-Centered Medical Home Program which now includes over 320,000 member and 1,400 doctors. Early results show improved quality and lower costs. Horizon BCBSNJ announced PCMH with Hunterdon Healthcare Partners and an ACO with Barnabas Health for Medicare Advantage members.
- The Horizon Foundation for New Jersey and the New Jersey Statewide YMCA Alliance expanded "Healthy U," a childhood anti-obesity program, into an additional 15 New Jersey schools for the 2013-14 school year.
- Horizon BCBSNJ announced in October that Horizon NJ Health - its Medicaid subsidiary company -- was recognized as New Jersey’s top-ranked Medicaid plan for 2013-14 by the National Committee for Quality Assurance (NCQA).
- On September 24, Horizon Connect completed its first year of operation, recording more than 3,500 customer visits and 667 policy sales.
- On October 1, the Affordable Care Act's Health Insurance Marketplaces opened and Horizon BCBSNJ, one of only three health insurers in New Jersey, began offering five products on the Marketplace.
- Horizon BCBSNJ announced in January that an additional 300 doctors joined its Patient-Centered Medical Home Program, bringing total participation to 1,300 providers at 450 office locations. The company in January also announced the creation of the state's first Patient-Centered Pregnancy and Delivery Episode of Care Program (Program) designed to deliver better outcomes, better patient experience, and lower costs through better coordination of care for pregnant women.
- In the first four months of 2014, Horizon BCBSNJ announced four new ACO agreements in different regions of the state to improve care and patient outcomes. The agreements were reached with Edison-based JFK Medical Center, the Hackensack-Physician Hospital Alliance in North Jersey, the LHS Network in South Jersey, and Teaneck-Based Holy Name Medical Center. The four ACOs benefit a combined 41,000 Horizon BCBSNJ members.
- In March, Horizon BCBSNJ held a three-day "Insure-a-thon," with extended sales hours and outreach, to accommodate consumers seeking to purchase health insurance coverage prior to the Affordable Care Act's March 31, 2014 enrollment deadline.
- In April, Horizon BCBSNJ announced that Standard & Poor's (S & P), a leading provider of investment and credit opinions to global capital markets, reaffirmed Horizon BCBSNJ’s financial rating of "A."
- In June, Horizon BCBSNJ announced the creation of new patient-centered EPO products for small group business accounts. The products offered lower premiums for businesses and reduced out of pocket costs for patients when members chose to receive care at a patient-centered practice.
- Horizon NJ Health, the state's largest managed Medicaid health plan and an Horizon Blue Cross Blue Shield of New Jersey company, announced that it would launch a Managed Long-Term Services and Supports (MLTSS) program beginning July 1, 2014.
- In celebration of a decade of supporting community organizations throughout the state, The Horizon Foundation for New Jersey, in July, awarded Wheaton Arts - its 1000th grant recipient - a special extra anniversary grant of $10,000 for general operating support.
- In July, Horizon BCBSNJ announced 2013 results from its patient-centered Medical Home Program, which analyzed claims of more than 200,000 members. The results showed that patient-centered members had higher percentages of compliance with medical screenings and diabetes control than members in the general member population, and lower rates of emergency room visits, hospital admissions and total cost of care.
- In September, Horizon BCBSNJ announced an investment in COTA, Inc., an oncology-management technology company based in Hackensack, New Jersey. COTA’s real-time data platform assists physicians with providing personalized and optimal care to their cancer patients as well as enabling practices and health plans to move to value-based care models that reward the quality, not quantity, of care cancer patients receive.
- Horizon BCBSNJ announced in October a new Episode of Care program with Regional Cancer Care Associates (RCCA) – one of the nation’s largest oncologist physician groups -- to deliver highly specialized care for breast cancer patients. RCCA physicians, more than 100 specialists at 24 New Jersey locations, will be compensated on the quality, not quantity, of care their breast cancer patients receive.
- Horizon BCBSNJ announced in January that more than 750,000 of its members were receiving the benefits from the company’s patient-centered programs, which now included more than 6,000 participating network doctors.
- In March, Horizon BCBSNJ announced that its efforts to combat health insurance fraud resulted in $45.4 million in savings -- identified as a combination of monies recovered and losses avoided -- in 2014. The $45.4 million represents the highest/recovery prevention total since Horizon BCBSNJ created its fraud fighting, Special Investigations Unit (SIU) in 1983.
- In May, The Horizon Foundation for New Jersey announced a collaboration with the Boys and Girls Clubs of New Jersey to create a state-wide program – BEAM (Breathe Easier with Asthma Management) - to improve awareness, education and treatment of asthma. With a $500,000 Foundation grant, BEAM began serving 2,500 children ages 5-18, at 12 BCGNJ sites that are located in nine New Jersey counties where asthma is prevalent.
- In August, Horizon BCBSNJ released 2014 results from its patient-centered program, which showed continued improvements in quality and cost containment metrics among members attributed to patient-centered doctors. Among the results, patient-centered members, as compared to those members in traditional practices, had a 6 percent higher rate of diabetes control and an 8 percent higher rate in colorectal cancer screenings The findings also showed a 5 percent lower rate in emergency room visits and 9 percent lower total cost of care.
- In September, Horizon BCBSNJ, along with several of New Jersey's leading health systems and a major multispecialty physician group, announced the formation of a unique, first-of-its-kind statewide alliance. The OMNIA Health Alliance is committed to radically altering how health care is financed and delivered in New Jersey to reward value, which it defines as high quality care, an enhanced patient experience, and lower total cost of care.