New Jersey Voters Oppose Tiered Insurance Plans Such as Horizon's Controversial OMNIA

TRENTON, N.J., May 19, 2016 /PRNewswire/ -- In a survey of registered New Jersey Voters, 70% of those polled stated that they opposed Horizon's controversial OMNIA plan – an insurance plan that has created a tiered web with huge hospital systems as its base, while excluding some of the state's best and highest rated hospitals. Notably, 70% of those who identified as Horizon customers also opposed the OMNIA plan, while 66% of them supported a freeze on enrollment into tiered plans until the state can set guidelines. In fact, Horizon customers supported a freeze on enrollment even more than voters overall (59%).

Horizon's OMNIA plan, launched into New Jersey in September of 2015, restricts patient access to care only through doctors and hospitals that it has selected, based on criteria that it has not publicly divulged. Patients may have to travel further to access care at OMNIA's Tier 1 hospitals or doctors, or pay more to access their doctor or hospital designated as Tier 2.

"The survey questions on this topic were very neutral, to get a better understanding of the base reaction to the OMNIA plan," stated Jeff Liszt, Partner of Anzalone Liszt Grove Research, the firm who conducted the study.  "Essentially, we simply asked for a response after providing a description of the plan: 'Horizon is the state's largest insurer. The company created a Tiered Hospital system whereby patients covered under its new OMNIA plan only could go to hospitals designated as Tier One to receive discounted rates.  If the patient's usual hospital was designated as Tier Two, the patient would have to pay more out-of-pocket due to higher co-pays and deductibles. The goal of this system is to encourage patients to only use Tier One facilities.  Horizon claims that this structure will lower costs throughout the health care system.'"

"It also is important to note that there is widespread awareness of how powerful Horizon is and its impact on health care in New Jersey. And, there is a widespread sense that Horizon only is looking out for itself," added Liszt. "61% of voters surveyed said that Horizon puts profits above people; while 55% of Horizon customers surveyed said the same. Additionally, 57% of voters said that Horizon 'has too much influence and power in New Jersey', while a surprising 61% of Horizon customers said the same."

"We are not surprised by the responses to Horizon's OMNIA plan," stated Steve Goldman, an attorney representing many of the hospitals not included in the OMNIA Tier 1 plan. "Excluding certain hospitals from Tier 1 places a burden on the patient and their family to get to a Tier 1 hospital. Patients may not have readily available access to health care unless they are willing to pay more or travel long distances. Many patients also may be forced to find a new doctor or hospital – even in the middle of treatment."

Goldman continued, "Horizon, as New Jersey's largest health care insurer, has failed to provide any transparency to health care consumers and providers as to how the providers were being placed into tiers. The arbitrary and secretive way in which many quality health care providers were treated will have a potentially devastating impact on communities whose hospitals have been unfairly placed into tier 2. This creates a terrible precedent for the needed revisions to the health care delivery system in New Jersey and compromises patients access to care. No one but Horizon knows the matrices and criteria used to place providers into tiers and some of the state's highest rated hospitals and doctors have been placed into tier 2.

The NJ legislature should immediately freeze enrollment in such tiered plans until guidelines can be established to provide transparency and network adequacy to protect patient's access to care," added Goldman. "Such a temporary freeze will allow the health care system in New Jersey the opportunity to get the full benefit of tiered healthcare plans in an appropriate way."

SOURCE Steve Goldman