Case Study: Horizon Blue Cross Blue Shield of New Jersey achieves a fully integrated healthcare environment with Orion Health

Creating a Fully-Integrated Healthcare Environment

Horizon Blue Cross Blue Shield of New Jersey, a major insurer serving 3.6 million members and a leader in state-wide value-based programs, faced fragmented encounter-based workflows, entrenched EMR and data silos, and the need to create a longitudinal medical record to enable virtual integration and better population health management. To tackle these challenges Horizon selected Orion Health and its Amadeus-based HealthSphere solution to consolidate clinical and claims data and drive provider adoption.

Orion Health implemented the Amadeus platform, Clinical Portal and HealthSphere repository (hosted on AWS with Open/FHIR APIs) to integrate diverse provider systems, enable real-time data access, and support shared analytics and care plans. As a result, Horizon achieved enhanced payer–provider collaboration, measurable clinical and cost improvements — a 4% lower total cost-of-care trend, 4% fewer hospital inpatient admissions, 6% higher colorectal screening rates and 7% higher breast cancer screening rates — plus reduced duplicated or rejected treatments and improved scalability for future personalized-medicine initiatives with Orion Health.

Horizon Blue Cross Blue Shield of New Jersey

Joe O’Hara

Director Healthcare Marketplace Innovations