Pilot health-care program focuses on prevention

    For some New Jersey residents, health care may become more personal with a pilot program called “Patient Centered Medical Home.”

    Horizon Healthcare Innovations, a subsidiary of Horizon Blue Cross Blue Shield, is teaming up with 63 primary-care physicians. The goal is to improve care through prevention.

    Much of a physician’s practice is driven by the volume of patients examined. Under the current fee-for-service system, doctors are left with little opportunity to focus on in-depth needs or follow-up.

    The new program will pay doctors a set fee and incentives for timely screenings rather than basing payments on how many tests are run.

    Ann Weiss is with the Robert Wood Johnson Foundation, which specializes in health-case issues. She said programs such as this one look promising. Paying for additional services are offset because emergency care costs decrease, she said.

    “Especially for the sickest patients, the ability to catch problems early prevents serious complications,” she said. “It keeps patients out of the hospital, keeps them healthy and keeps them caring for their own conditions.”

    The program will serve 24,000 members of Horizon, the state’s largest health-care provider.

    Richard Popiel, Horizon Healthcare Innovations president and CEO, said coordinating care is crucial.

    “You have to work out how that plan will be executed in the home environment, coordination with specialists, making the appropriate referrals and making sure the patient follows through on the recommendations,” he said.

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