Poll: Tiered Health Plans — Good, Bad, or Indifferent for Patients and Providers?

NJ Spotlight | September 17, 2015 | Polling
Everyone likes to save money, but what if it means not seeing your primary care doctor or visiting the hospital where you’ve been treated?

With great fanfare, Horizon Blue Cross Blue Shield of New Jersey has rolled out the OMNIA Health Alliance, a group of hospitals that say they’re committed to transforming healthcare. Instead of paying providers based only on the number of services they deliver, alliance participants will be paid partly for furnishing high-quality care, and partly for controlling costs.

How this works should become clear next month, when public workers who are in the State Health Benefits Program will be offered a “tiered” health plan. Patients who go to OMNIA members and other Tier 1 hospitals should see out-of-pocket costs cut by $2,000 a year, and will pay lower monthly premiums. The catch? In order to get those savings, some patients will have to give up on doctors or hospitals with which they have long-time relationships.