'We must be in a position to compete': Horizon Blue Cross pitches regulators on reorganization

Horizon Blue Cross Blue Shield of New Jersey executives urged state regulators to approve changes to its corporate structure, the Asbury Park Press reported Oct. 7. 

The payer's executives were speaking at one of three public hearings scheduled in October. Within a month of the final  hearing on Oct. 17, New Jersey's insurance commissioner will formally decide whether to approve the company's conversion from a nonprofit health services organization to a nonprofit mutual holding company. The change will allow the company to create for-profit subsidiaries through the acquisition of providers or pharmacy benefit managers. If approved, Horizon will pay New Jersey $1.25 billion over 25 years. 

"We must be in a position to compete (with for-profit companies) if we are to continue our mission," Jennifer Velez, senior vice president and general counsel for Horizon, said at the hearing, according to the report. 

Horizon officials said the company has been hamstrung by rules restricting how much it can invest in technology, data analysis and partnerships that could improve its customers' health, according to the report. 

Brandon Cruz, a physical therapist, expressed skepticism about the proposed change at the hearing, according to the report. He alleged that Horizon has kept his reimbursement rate frozen at the same level since 2005, which has forced him to spend less time with more patients to stay in business. 

"It comes down to patients and providers," he said. "Decreasing reimbursement rates decreases quality."

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Top 40 articles from the past 6 months