Company History - Horizon NJ Health (2024)

2014

• Membership reached more than 727,000 enrollees.
• Horizon NJ Health launched the Managed Long Term Services and Supports (MLTSS) on July 1, 2014. The MLTSS program serves individuals who have disabilities and/or are over 65 years of age, qualify for Medicaid, and who meet criteria nursing home level of care.
• Horizon NJ Health selected to participate in National Substance Use Collaborative. The focus of the collaborative is evidence-based best practices for prescription drug abuse identification and treatment.

2013

• Membership reached more than 576,000 enrollees at the end of 2013.
• Company received earned a Commendable Accreditation status from the National Committee for Quality Assurance (NCQA). NCQA Health Plan Accreditation is a nationally recognized program that evaluates the quality of health care services that health plans provide to their members. Health Plan Accreditation performance results are publicly reported in five categories including: Access and Service, Qualified Providers, Staying Healthy, Getting Better and Living with Illness.

2012

• Membership reached more than 565,000 enrollees at the end of 2012.
• The NJ FamilyCare/Medicaid “HMO Performance Report” rated Horizon NJ Health as the highest Medicaid managed care plan in New Jersey.
• Company received Health Plan reaccreditation from URAC, an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.
• Professional staff, health educators and Team NJ participated in 707 statewide community, school, faith-based and health events providing health screenings, outreach and education.

2011

• Enrollment reached a milestone of more than 500,000 members in the Medicaid, NJ FamilyCare and NJ FamilyCare ADVANTAGE programs in October of 2011.
• The Pharmacy Multi-Lingual Program received the Medicaid Health Plans of America Center for Best Practices’ Award for Cultural Competency.
• Two new Care-A-Vans, mobile health units, were added to the company fleet of vehicles. Care-A-Vans and the health professional team, known as Team NJ, participated in more than 460 health events, screenings and educational programs in communities across New Jersey.

2010

• Membership reached more than 470,000 enrollees at the end of 2010.
• Horizon NJ Health began offering services on NaviNet.net for providers, including on-line referrals, claim status and member eligibility inquiries.

2009

• In December 2009, Horizon NJ Health reached more than 435,000 members and attained a 46% market share.

2008

• Enrollment reached more than 376,000 members by January 2008.
• In January 2008, Horizon NJ Health was the first company to offer NJ FamilyCare ADVANTAGE, a program for children without health care coverage and whose family income levels make them ineligible for Medicaid or the NJ FamilyCare.
• Rated as New Jersey’s highest ranked Medicaid managed care company by the Michigan Peer Review Organization in the State of New Jersey’s Annual Assessment for Medicaid HMOs.
• The Community Outreach and Health Education program participated in more than 315 community, school and faith based organization health fairs and events.

2007

• In January 2007, membership reached 313,000 members and the company gained 43% of market share.
• Community Outreach and Health Education program continued to expand outreach at more than 200 community events and health fairs throughout New Jersey.
• Horizon NJ Health expanded its Care-A-Van program to include a second mobile health and wellness unit for statewide outreach, health education and screenings.
• The Dancing For Your Health program is launched to demonstrate the health benefits of popular dances and how to fight obesity.

2006

• In January 2006, membership increased to 283,000 members.
• The Adolescent Wellness project was launched resulting in a 20% increase in adolescent wellness visits and Hepatitis B vaccinations.
• Horizon NJ Health introduced its new mascot "NJ" who helps teach children good health, nutrition and dental care.
• Horizon NJ Health President and Chief Operating Officer Karen Clark named as one of the Top 25 Minority Health Executives in the Nation by Modern Healthcare Executive Magazine.

2005

• In January of 2005, membership increased to more than 276,000 members.
• Horizon NJ Health launched its first professionally staffed, mobile health and wellness unit. The Care-A-Van is used for outreach, health screenings and education at community, school and faith-based health fairs and events statewide.
• On July 13, 2005, the Family Health Care Coverage Act was signed into law by Acting Governor Richard J. Codey, expanding NJ FamilyCare for working adults and improving access to approximately 264,000 children.
• The Physician Recognition Program was established to acknowledge the work of physicians, nurse practitioners and other network health care professionals who make a difference in the health and wellness of members.

2004

• In January 2004, enrollment reached 269,000 members in all 21 counties.
• Horizon/Mercy officially changed its name to Horizon NJ Health on June 1, 2004.
• URAC renewed Horizon NJ Health's Health Plan accreditation.
• Received Best Clinical and Administrative Practice (BCAP) honor from the Center for Health Care Strategies, Inc., for the Emergency Room Pilot Project in partnership with Newark Beth Israel Hospital. The honor sited the project as a model for expanded outreach and partnerships with other hospitals.

2003

• In January 2003, Horizon Blue Cross Blue Shield of New Jersey acquired full ownership of Horizon/Mercy.
• Karen L. Clark, who joined Horizon/Mercy as Chief Operating Officer in 2002, became President and Chief Operating Officer for Horizon/Mercy.
• The NJ State Senate honored Horizon/Mercy for a decade of service and commitment with an official State Resolution presented on the floor of the NJ State Senate by Senate Co-Presidents: Senator Richard J. Codey and Senator John O. Bennett.

2002

• The American Association of Health Plans (AAHP) in a published report, Innovations in Medicaid Managed Care, recognized Horizon/Mercy for five innovative programs that improve the health and well-being of Horizon/Mercy members. The programs recognized were the Asthma Relief Program, GEMS Prenatal Program, the Care Coordination Unit, CHAMPS Program, and the Congestive Heart Failure Program.
• In May 2002, Horizon/Mercy convened an NJ Nursing Summit to highlight the role of nursing in managed care and to address health care disparities.
• In June 2002, Horizon/Mercy was awarded Health Plan full accreditation by URAC, setting a standard of excellence and a benchmark for quality.

2001

• In April 2001, Horizon/Mercy reached the 200,000-member mark. By the end of 2001, Horizon/Mercy membership had reached 256,000.
• In 2001, Horizon/Mercy implemented its Diabetes Management Program to improve the delivery of health care for members who are diagnosed with diabetes through appropriate and effective management.
• In 2001, Horizon/Mercy started its Congestive Heart Failure (CHF) Program, which utilizes nursing interventions and innovative case management techniques to reduce the hospital admission rates and improve the quality of life for Horizon/Mercy's members with CHF.

2000

• The State of New Jersey expanded the NJ KidCare Program to include adults, and the new program was named NJ FamilyCare.
• By the end of 2000, Horizon/Mercy had 180,000 members.
• In 2000, Horizon/Mercy started its Care Coordination Unit for members with special needs. This department helps Horizon/Mercy's special needs members by coordinating their health care, social, and mental health services.

1999

• In February 1999, MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue acquired 19,000 AmeriHealth members.
• In March 1999, MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue officially changed its name to Horizon/Mercy.
• In March 1999, the company acquired 20,000 members from American Preferred Provider, Inc., increasing plan enrollment to 160,000 members.
• In 1999, The CHAMPS Program (Children's Health Assessment and Maintenance of Preventive Services) was established to develop collaborative relationships between the provider and the parents of the children enrolled, a program designed to lead to well-child visits, immunizations, and lead screenings.

1998

• In February 1998, MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue expanded into the remaining 21 New Jersey counties, becoming the first Medicaid Managed Care plan to be offered statewide.
• In March 1998, New Jersey began offering its version of the State Children's Health Insurance Program (SCHIP) called NJ KidCare.
• In July 1998, MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue reached the 100,000-member mark.
• In 1998, the Horizon NJ Health Asthma Relief Program was started to improve the quality of life for MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue's members with asthma.

1997

• By May 1997, MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue had reached 80,000 members.
• During June 1997, the company acquired 16,000 Harmony Health Plan members.
• In 1997, MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue started its Social Case Management Outreach Program. Staffed by a team of professional social and outreach workers, the program was designed to offer members support with not only health issues, but also social issues that could be barriers to members receiving needed health care services.

1996

• In June 1996, MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue surpassed U.S. Healthcare and became the New Jersey market leader for Medicaid Managed Care.
• By the end of 1996, MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue was in 14 counties. During 1996, the company expanded into Atlantic, Bergen, Burlington, Cumberland, Gloucester, Mercer, Middlesex, Monmouth, Ocean, Passaic, and Union.

1995

• By October 1995, two years after partnership was formed, MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue's enrollment was at 27,000.
• The GEMS (Getting Early Maternity Services) Prenatal Program started in 1995. The program was designed to provide case management services to pregnant women who might be at risk for premature delivery or other pregnancy-related complications.

1994

• In January 1994, MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue's first members became effective.
• In 1994, MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue expanded into Essex and Hudson Counties.

1993

• In October 1993, Horizon Blue Cross Blue Shield of New Jersey and Mercy Health Plan (a subsidiary of Mercy Health System of Southeastern Pennsylvania) entered into a partnership to form MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue (MHPNJ).
• In November 1993, MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue began marketing to the eligible Aged, Blind Disabled (ABD) population in Camden County, NJ.
• In December 1993, MERCY HEALTH PLAN of New Jersey on behalf of HMO Blue began marketing to the eligible Aid to Families with Dependent Children (AFDC) population in Camden County, NJ.