A Visit to Horizon Blue Cross Blue Shield of New Jersey: Student Perspectives and Takeaways
- Rutgers AMCP
- Apr 17, 2018
- 3 min read
A Visit to Horizon Blue Cross Blue Shield of New Jersey: Student Perspectives and Takeaways
April 17th, 2018
14 students from the Ernest Mario School of Pharmacy at Rutgers University visited Horizon Blue Cross Blue Shield of New Jersey to learn more about the roles pharmacists play in managed care.
The Rutgers Academy of Managed Care Pharmacy (AMCP) chapter advisor, Dr. Saira Jan (Director of Pharmacy Strategy and Clinical Integration) gave opening remarks and was followed by a presentation by Mr. David Gambino (VP & Chief Pharmacy Officer) who gave an overview of Horizon’s pharmacy department and new trends in healthcare. He stressed the importance of delivering novel, patient-centered programs that reward value-based model rather than a fee-for-service based model and discussed the challenge in getting reimbursement right with specialty drugs that are becoming increasingly more popular. This introduction was then followed by an interactive discussion of Horizon’s Behavioral Health Integration led by Ms. JoAnn Karcic (Director of Behavioral Health) and Ms. Rachel Goldberg (Behavioral Health Implementation Manager). Ms. Goldberg started the discussion with a “myth-or-fact” game to engage student participation in introducing basic behavioral health concepts and Ms. Karcic talked about the intercollaborative initiatives Horizon has been participating in.
The agenda then transitioned into the episodes of care program at Horizon led by Ms. Kim Eason (Manager of Provider Partnerships). Ms. Eason explained that the main objective of this program is to standardize and optimize care and cost of care and further emphasized the healthcare paradigm shift from fee-for-service model to value-based model that Mr. David Gambino introduced. Subsequently, there was a talk on informatics and the role of data in managed care in predictive modeling and outcomes. This topic was led by Mr. Jeffrey Vernice (Director of Analytics Business Partnerships), who talked about the growing opportunities for pharmacists in healthcare informatics. Many of the students found this talk on big data and data science to be particularly interesting because of the lack of prior exposure to this field. Afterwards, Mr. Jonathan Pearson (Director of Corporate Social Responsibilities) gave a presentation on the Horizon Foundation. The Horizon Foundation is a charitable organization create in 2004 to promote health prevention and education programs. Mr. Pearson explained the various initiatives that Horizon has been leading to improve quality healthcare for all New Jersey residents as well as enhancing the arts and culture opportunities. One of the programs Horizon helped support was the Rutgers University Student Health Ambassador Program for Diabetes Care. The purpose of this initiative was to provide early and effective identification of diabetes and improving overall patient outcomes.
Lastly, to conclude the site visit there was a panel discussion of clinical pharmacists at Horizon that focused on explaining their various roles. The panelists of clinical pharmacists included: Dr. Shery Gadalla (Population Management), Dr. Hannah Kim (Formulary Management), Dr. Timothy O’ Shea (Health Systems Interface/Specialty), Dr. Kavita Parmar (Utilization Management/Specialty), and Dr. Jane Sun (Medicare). Altogether, students found the site visit to Horizon very informative and interesting because it exposed them to different areas of pharmacy and gave them first hand exposure to the corporate culture at a managed care organization.
Peter S. Lee is a student at Rutgers University, and is anticipated to graduate with a doctorate in Pharmacy in 2021. Peter is the Director of Site Visits & Membership for Rutgers AMCP Student Chapter.
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