Horizon Healthcare Services is growing good health for Garden Staters. The company, dba Horizon Blue Cross Blue Shield of New Jersey, is New Jersey's top health insurance provider, serving about 3.6 million members. The not-for-profit company, a licensee of the Blue Cross and Blue Shield Association, offers traditional indemnity and managed care plans, including HMO, PPO, and POS plans, as well as Medicaid and Medicare Advantage coverage options. It also provides dental and behavioral health coverage and manages workers' compensation claims.
Horizon Healthcare has offices in Harrison, Mt. Laurel, Newark, Wall, and West Trenton, New Jersey.
Horizon Healthcare's largest single account is New Jersey's State Health Benefits Program, which covers nearly 700,000 state government workers. The company also covers federal employees through the Blue Cross and Blue Shield (BCBS) Association's Federal Employee Program.
The company also participates in state Medicaid and FamilyCare programs through its Horizon NJ Health subsidiary, which has some 500,000 members and counting. Horizon Healthcare has also been enrolling customers in its Medicare Advantage program. Other businesses within the company include its Horizon Dental dental plan (which boasts more than 1 million members in New Jersey) and its workers' compensation managed care program, Horizon Casualty Services, which also provides personal injury protection.
Along with its portfolio of BCBS-associated subsidiaries, Horizon Healthcare provides managed care and traditional health plans through its non-BCBS licensed affiliates, Rayant Insurance Company of New York and Rayant Insurance Company of Pennsylvania. It also offers life and disability insurance (underwritten by other insurers) through Rayant Insurance Agency. Other Rayant companies include Rayant Healthcare Administrators and Rayant Dental Services. All of the Rayant companies offer their products to small to midsized businesses and other consumers in New York and Pennsylvania.
Sales and Marketing
Horizon Healthcare serves customers including large and small businesses, multi-state employers, government employees, families, individuals, and Medicare and Medicaid beneficiaries.
Horizon Healthcare reported a 9% increase in revenues to $9.4 billion in 2012 due to higher premiums and enrollments in its Medicare and Medicaid, individual, and state health plan programs. Despite its successful efforts to grow in the individual and government customer segments, the company has seen a decline in some of its group account segments in recent years due to troubled economic times (and thus employment levels).
Net income decreased in 32% to $200 million in 2012, however, because of higher expenses related to medical and benefit cost increases stemming from membership growth.
Like all US health insurers, Horizon Healthcare is continually grappling with the problem of rising health care costs. Along with going public, the company is exploring a number of ways to keep expenses under control and remain competitive, including offering lower-cost, consumer-directed products (branded Horizon MyWay) that place more financial and decision-making responsibility on individual and group policyholders. The company is also promoting its low-cost small business plans and expanding its government health programs, which it believes will be in higher demand under new federal health reform laws.
The company is also trying to keep its members healthy through prevention programs that promote fitness, provide reminders for health screenings, and help members manage chronic diseases. All of these wellness and consumer responsibility measures coincide with the federal health reform goal of lowering the overall cost of care in the US. To further this ambition, in 2010 Horizon formed a new subsidiary, Horizon Healthcare Innovations, which aims to increase care collaboration among doctors, hospitals, and other health professionals. The company is also upgrading its IT systems, including claims processing and benefit coordination, to help providers lower their administrative costs.
Mergers and Acquisitions
To expand IT services, Horizon teamed up with fellow Blues providers Independence Blue Cross and Highmark to partner with health IT provider Lumeris in 2012 to acquire NaviNet, which provides a real-time communication network for physicians, hospitals, and health insurers. NaviNet connects 75% of doctors in the US and in 70,000 physicians and hospitals throughout the Blues' service areas.
In 2008 Horizon Healthcare filed an application to convert to a for-profit corporation; however, it stopped working on the proposal in 2010 amid intense public and government scrutiny over the conversion plans (as well as its executive compensation practices). The change would have given Horizon Healthcare access to capital markets that the company believed would have helped it remain competitive in a changing health care environment.