Horizon Blue Cross and Blue Shield of New Jersey launched its Episodes of Care Program in an effort to improve healthcare costs and quality and reward physicians for achieving those goals. Now, the payer has released the 2014 EOC Program results.
Here are six takeaways.
1. Horizon BCBSNJ released episode of care results for hip replacement, knee replacement, knee arthroscopy, pregnancy and colonoscopy.
2. The payer reported 100 percent fewer hospital readmissions for knee arthroscopy patients and 22 percent fewer hospital readmissions for knee replacement patients.
3. In 2014, there were 37 percent fewer hospital readmissions for hip replacement patients.
4. The payer also reported a 32 percent reduction in unnecessary C-sections.
5. "The Episode of Care model is a game changer in the progress from fee-for-service to value-based contracting," said Charles A. Accurso, MD, a Hillsboro gastroenterologist in Horizon BCBSNJ's Colonoscopy EOC. "By tying financial incentives to quality, it improves the care of the patient while also decreasing costs."
6. Horizon BCBSNJ paid 51 specialty medical providers approximately $3 million in shared savings through its EOC program. The physicians received the bonuses for achievement in cost savings, patient satisfaction and quality in 2014.