Tuesday, September 22, 2015

Hudson Dems slam Horizon plan as 'catastrophic'

A Horizon VP called the Dems' claims "preposterous."

JERSEY CITY -- Hudson County Democrats today blasted Horizon Blue Cross Blue Shield of New Jersey's planned partnership with 34 hospitals, saying it threatens the financial stability of the state's other 38 medical centers.

Five of those hospitals are in Hudson County, including Christ Hospital on Palisade Avenue, where Democrats met this afternoon to denounce the Horizon plan, set to go into effect next year.

They did not mince words.

It would be "catastrophic," said Jersey City Mayor Steve Fulop.

It would lead to "unbearable" cost increases, said state Assembly Speaker Vincent Prieto, of Secaucus.

It's a "dirty, underhanded trick," said Freeholder Anthony Romano, of Hoboken.

Horizon, the state's largest insurer, announced on Sept. 10 that it plans to offer lower-priced policies that would offer discounts for patients at 34 selected hospitals. The intent, Horizon says, is to move away from a "fee for service" model and move to a model that rewards quality service, but today Prieto said he doubts what the company is saying.

"A lot of times when I see something that looks too good to be true, sometimes it is," Prieto said.

Minal Patel, a medical doctor and a Horizon senior vice president and chief strategy officer, told The Jersey Journal that the Democrats' allegations are the result of misinformation.

"The notion that this is going to decimate the health-care infrastructure in Hudson County is preposterous," Patel said.

Horizon's plan works like this: there will be a "tier one" of 34 hospitals where patients in the plan would save money on premiums, deductibles and co-pays. Horizon customers would still be able to go to the "tier two" hospitals, but the out-of-pocket discounts would not be available there. Every hospital in Hudson County currently in Horizon's managed care network, except Jersey City Medical Center-Barnabas Health, would be in the second tier.

Democrats warned today of two consequences of the Horizon plan: patients would flock to tier one medical centers to get a better deal, leading to financial problems for tier two hospitals; or patients who aren't that mobile would face higher costs at tier two hospitals.

Patel said the Democrats are wrong. Patients would indeed see lower costs at the tier one hospitals but premiums all around would be lower, so the costs for patients visiting tier two hospitals would be "essentially the same" as costs are now, he said.

Patel added that the new plan is voluntary, and that it would likely take 10 years or more for a significant portion of 3.8 million of Horizon's customers to move into it.

There is a hearing scheduled in front of the state Senate on Oct. 5 to discuss Horizon's plan.

Terrence T. McDonald may be reached at tmcdonald@jjournal.com. Follow him on Twitter @terrencemcd. Find The Jersey Journal on Facebook.

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