Northern New Jersey | New Jersey | 2023 | Market Overview Brief

Northern New Jersey is both a prime example of current pandemic intervention and a model for future healthcare payment reform. The market’s most powerful healthcare entities—Horizon Blue Cross Blue Shield of New Jersey, RWJBarnabas Health, and Hackensack Meridian Health—partner to develop bundled payment models and protocols for managing social determinants of health. Horizon and HMH also partner to offer a new Medicare Advantage product line under the Braven Health brand. The payer/provider mash ups are a next level intervention for managing healthcare inflation, all with an eye toward coordinating care for the sickest patients and keeping healthy members from progressing toward illness. While a construction boom to add outpatient centers and medical clinics is slowing due to pandemic-related financial concerns, IDNs are expanding key service lines, particularly cancer care (with innovative immunotherapies), cardiology, and behavioral health care. Social determinants of health continue to rise in importance as payers and providers partner to address these social concerns that dramatically affect patient health and well-being. Expect Northern New Jersey providers to take on more risk in 2021 and possibly receive reimbursement for managing social determinants of health.

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