Population health relies on provider collaboration, nurse coordinators, data sharing
Population health management is a vital part of an insurer's overarching goal to lower costs and improve quality care. At Horizon Blue Cross Blue Shield of New Jersey, population health means partnering with providers to offer valuable claims information to help them better manage patients with expensive chronic conditions.
Beginning more than four years ago with a small pilot, Horizon has since expanded its program statewide and incorporated insights and learnings along the way.
To learn more about how Horizon has successfully managed its population's health, FierceHealthPayer spoke with Steven Peskin (pictured right), Horizon's senior medical director for clinical innovations.
FierceHealthPayer: Can you provide a high-level overview about how Horizon approaches population health management, and how you control costs and reduce utilization?
Steven Peskin: We started around four a half years ago collaborating with clinical partners. We provide a lot of information to our clinical practices, especially around risk stratification. We work very collegially with our practices to help them develop processes for managing patients with chronic conditions or who risk developing chronic conditions.
A cornerstone to our work is what we call population care coordinators. We now have more than 250 nurses across the state of New Jersey who work in the physician practices. There may be a dozen working in a large system or there might be one coordinator for two or three small practices. Although they're employed by the actual practices, these folks are trained by Horizon. We provide a two-day training at the beginning of their tenure, so to speak, but it doesn't stop there. It continues with face-to-face mentoring, webinars and quarterly meetings. So that's a real lynchpin to the work that we've been doing with the practices.
FHP: Can you talk more about the care coordinators and what they do on a day-to-day basis? What specific benefits do they provide the practices?
Peskin: The care coordinators work metaphorically shoulder-to-shoulder, side-by-side with the physicians, the nurses and physicians' assistants in the clinical practices.