The Benefits of Keeping It Local: Make Your Workers’ Comp PPO Work for You!

New Jersey is a state unlike any other in the Northeast, with quick access to beautiful beaches and boardwalks, sporting events and arenas, an endless nature preserve and proximity to NYC. Similarly, the Garden State’s workers’ compensation program is unlike any of its neighbors’, operating with care direction and without a state-mandated fee schedule.

Horizon Casualty Services, Inc. (HCS), a fully owned subsidiary of Horizon BCBSNJ, has conducted business in the workers’ compensation space since 1994. With more than 25 years of New Jersey workers’ compensation experience, HCS understands the importance of working closely with the network providers, as well as balancing the needs of its clients to ensure that it delivers a valuable product to the market.

In Relentless Pursuit of Our Mission

Jacqueline Alonso, President, Horizon Casualty Services, Inc.

In 2022, newly appointed HCS president Jacqueline Alonso challenged HCS to think differently, be innovative and truly understand what inspires the team. Alonso stated, “We need to focus on the ‘why’ of what drives us to do the work that we do. We know New Jersey. This is our home field. The doctors in our PPO network are our colleagues, friends, neighbors and family, and they work in our communities. Our providers know and trust HCS.”

“As a mission-driven organization, we are focused on helping injured workers access highly qualified health care professionals that deliver comprehensive, appropriate and effective care,” Alonso continued. “It is our drive and focus on New Jersey that has allowed HCS to thrive in the market.”

We engage with our network on a proactive basis and regularly check in to see how we are doing. Heidi Coluni, HCS director of network services, stated, “It can be challenging to shift mindsets from reactive to proactive, but that’s just what we did with our network team. This past year has been transformative for our organization, and we have retrained our team to think like a provider and anticipate their needs.”

“It could be a simple question that we are able to address or potentially an in-depth inquiry that requires more involved research,” Coluni added. “Regardless, we take both scenarios very seriously and work to ensure that our providers’ needs are met. In turn, our network of providers ensure that our injured workers are receiving the best care.”

Building on a History of Excellence

Heidi Coluni, Director of Network Services, Horizon Casualty Services, Inc.

Over the past decade, HCS has refined its Outcomes Focused Network (OFN) as part of its overall health care value strategy, with the goal of providing appropriate, timely, cost-effective and evidence-based care to injured workers with a focus on the initial treatment phase.

The providers participating in the OFN truly understand the importance of appropriate, conservative care, where the clinicians are committed to returning their patient to work and resuming their lives.

HCS regularly reviews and monitors provider outcomes to ensure that our OFN providers are the leading workers’ compensation health care professionals in the State of New Jersey. In turn, we have established a deep trust with our existing client base. It is through this regular and rigorous review process that our OFN providers are able to consistently deliver optimal medical outcomes for the injured worker.

The benefit of keeping it local boils down to geography, as well as the scale and quality of the HCS network, which is backed by the strength and longtime presence of Horizon BCBSNJ. The HCS team is committed to its mission: to ensure that every injured New Jersey worker receives the best treatment with the best medical outcomes.

For More Information

For more information, email Jed Hoban, HCS Business Development Executive, at [email protected] or visit HorizonBlue.com/HorizonCasualty/service-offerings/workers-compensation.

 About Us Horizon Casualty Services, Inc.
 Horizon Casualty Services, Inc., a subsidiary of Horizon Blue Cross Blue Shield of New Jersey, in business since 1994, is the #1 New Jersey workers’ compensation (WC) and personal injury protection (PIP) PPO. The company’s 100 percent direct-contracted provider network of New Jersey acute care hospitals, overall WC savings 61 percent below UCR, and with its deep focus on precision, an extremely low WC appeals rate of 0.2 percent. Its PPO results combined with its WC health care value and OFN strategy enables insurers to be the best at delivering quality medical care to claimants at the right cost — clearly a win-win for all stakeholders involved in WC claims.

This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Horizon Casualty Services, Inc. The editorial staff of Risk & Insurance had no role in its preparation.