About HORIZON Health Ventures

Mission 

Our mission is simple and clear.  At HORIZON Health Ventures we strive to introduce and implement integrated management strategies that improve the efficiency and accuracy of healthcare, saving time, money and potentially lives.

How We Work

At Horizon Health Ventures, we do more than just provide health care management solutions. It’s how we work that sets us apart.

WE LISTEN TO OUR CUSTOMERS
Sometimes saving money isn’t the only goal you want to achieve. There might be other variables you want to consider. At HORIZON Health Ventures we listen to our clients and our clients’ advisors to find out what they’re really looking for in a cost management program.

WE SPEED IT UP
If actionable information is power then why wait? All of our analytics, vendor proposals and contract generation are handled in-house so you don’t have to go from vendor to vendor to find what you’re looking for. We’ll save you a lot of time, and a lot of headaches.

WE BREAK IT DOWN
We don’t just hand you the numbers, we make them make sense. We’ll take the time to explain what the analytics are saying and make sure you fully understand the value proposition of our vendors and their contractual relationships.

WE GIVE IT AWAY
All of our analysis, proposal generation and consulting is free. At HORIZON Health Ventures we only get paid if you buy through one of our contracts and the good news is that the vendors are the only ones who’ll write a check for our services. As a client, you pay us nothing.

The HORIZON Story

From: Cory Easton, Our Founder

Most families have a story like mine. Several years ago a medical condition unexpectedly put my dad in the Emergency Room. We all know the ER is the best place to go for prompt treatment and skilled emergency care.  And in many situations, care is delivered by personnel who evaluate you by observing your appearance and communicating with you, your family and medical transport personnel.

But when my father arrived at the hospital, he could barely speak; he was hurting and confused. He wasn't sure of the medications he was taking nor could he tell the doctors treating him about his allergies to certain drugs. Before my mother arrived with his list of drugs and was able to outline his allergies and past medical conditions, the doctors treating him had to make some decisions. Unfortunately he was allergic to one of the medications they decided to give him, and a three hour stay in the ER quickly turned into a three day stay in the hospital.

My father could have died - all from a well-intentioned though uninformed effort to relieve his pain and suffering.

Still, my dad was lucky…he survived. But the experience was gut-wrenching not only for him but for our entire family, not to mention costly to his health plan sponsor. Following that incident my brother Todd determined there must be a better way to convey to doctors a snapshot of their patient's relevant medical information, medications, allergies and medical conditions during an emergency.

It took Todd and his partner Dennis Friedman nearly 9 years of research. The result was the Emergency Medical File (EMF) and the more advanced EMFqr. HORIZON Health Ventures introduced the EMF to health plan sponsors in early 2012 and today has an expanded portfolio of comprehensive healthcare cost management services, helping plan sponsors and the advisors that guide them to save time, money, and potentially lives.

I am proud of my brother for envisioning the value of the EMF, and I am equally as proud to have expanded upon our simple mission by integrating the EMF product within a broader services portfolio.

For health plan sponsors and  their advisors, we bring meaningful and actionable knowledge of the cost management strategies that exist in today's market and work diligently to ensure that their deployment is achieved with excellence and integrity.  For health plan members, no one should suffer like my father. Unfortunately his story and the ensuing personal and financial challenges are repeated multiple times each day in hospitals and other provider facilities around the country.

In an era of confusion, concern, and ever-escalating healthcare costs, stakeholders require proper guidance squarely focused on the challenges at hand, ensuring that both the benefits that they provide return a positive and productive return on their investment and that their beneficiaries obtain needed healthcare services in a safe, efficient and cost effective manner.

Thank you for your interest in HORIZON Health Ventures.

Sincerely,
Cory Easton
HORIZON Health Ventures, LLC

Wounded Warrior Project

On behalf of HORIZON Health Ventures, we take great pride in supporting our current and past service men and women all over the world through our contributions to the Wounded Warrior Project.  We contribute out of respect for our country and the sacrifices these Warriors make each and every day on our behalf.  And for those who have given all, and for those whose physical and emotional well-being has been compromised as a result of their sacrifice, we hope that our contributions help in some small way to ease their pain.

My father Ralph, my brother Eric and my father-in-law, James Mellon all served proudly in our military.  Ralph was in World War II, Rick served in the Vietnam War and Jim was in the Korean War.  They served their country with honor and carried that pride with them long after these conflicts ended – and for Ralph and Jim, until their passing.  By honoring the men and women of our military, we are honoring these three men who have and always will be our guiding inspirations to be the very best that we can be in serving our clients with the same level of  excellence and integrity as they have demonstrated in serving our country.

 

 

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Archives
Success Stories
Association Employer – New Jersey – HORIZON Solution: Employer Group Waiver Plan (EGWP)

Number of Retirees: 239
This Association had been managing their retiree pharmacy program and filing for the Retiree Drug Subsidy (RDS) since 2006 through its insurance carrier. After evaluation of current drug spend and projected RDS for 2014, the plan decided to move to a fully insured Employer Group Waiver Program (EGWP). Based on current enrollment, no change in plan design or drug plan, the group saved $430,000 or $1,800 PMPY. This was hard dollar savings and did not infer savings from the elimination of attestation, administration or from the elimination of OPEB liabilities.

Success Stories
Government Association - Washington, DC- HORIZON Solution: Employer Group Waiver Plan (EGWP)

Number of Retirees: 108
This Association had been managing their retiree pharmacy program and filing for the Retiree Drug Subsidy (RDS) since 2006 through its Pharmacy Benefit Manager (PBM). During the course of the relationship, the PBM never introduced the Employer Group Waiver Program (EGWP) to either the Association or their insurance broker. In May 2013, HORIZON Health Ventures introduced the concept of EGWP to the broker who immediately addressed the capability with the client. Keeping all pharmacy benefits the same, HHV was able to save this plan $189,000 or 28% of drug trend for 2014.

Success Stories
Municipal Employer –Michigan – HORIZON Solution: Employer Group Waiver Plan (EGWP)

Number of Retirees: 1,200
Managed for many years by the same carrier, this municipality moved their group retiree pharmacy program to HORIZON Health Ventures and its proposed Employer Group Waiver Program (EGWP) for a 13% savings to the plan. In addition, the group did so while improving their plan design on generic drugs. At the direction of HORIZON Health Ventures, the EGWP provider lowered copayments on generic products both at retail and mail thus resulting in greater steerage to lower cost products and thus a lower premium. In addition, based on this client’s plan year, (along with the new plan design adopted), the client was able to secure a rate cap for 2015 fixing their costs at a maximum liability until January 1, 2016.

Success Stories
Union – New Jersey – HORIZON Solution: RDS Reopening

Retirees Covered: 1,032
Reopening subsidy = $1,518,000
Additional subsidy = $280,000
18% additional subsidy recovered upon Reopening

Upon hiring HHV and RDS Reopening Services requested an audit of past Retiree Drug Subsidy filings from CMS. The request was approved and based on missed eligibility and inaccurate reconciliation of subsidy eligible claims, this client successfully Reopened their RDS filings from 2009-2012 recovering over $90,000 in additional subsidy. 

Success Stories
Municipality – New Jersey – HORIZON Solution: Pharmacy Benefit Management

Total Lives Covered – 2,900
Annual Drug Spend - $4,400,000
Issue – Adverse drug mix in the Proton Pump Inhibitor (PPI’s) category resulting in $297,000 in unnecessary drug spend.

Resolution – Plan design modification mandating PPI’s be purchased Over-the-Counter (OTC) along with full subsidy of a $0 copayment to the member.

Recommendation to eliminate member cost share for mandatory purchases of OTC PPI’s resulting in $177,000 net savings to the plan. Significant savings to both plan and member realized through slight modification of design and no member disruption.

Success Stories
Corporate Employer – Pennsylvania – HORIZON Solution: Medical Bill Review

Total Lives Covered – 400
Number of bills reviewed - 5
Total Amount of Hospital Bills Reviewed - $1,135,914
Negotiated Amount Paid by Plan Sponsor - $446,874

After hiring HHV for Cost Containment Services (Medical Bill Review), five out-of-network hospital bills (different patients with different health conditions) were reviewed for appropriateness and necessity. Due to the identification egregious billing practices, undocumented charges and reasonableness audit, successful negotiation was realized reducing the amount paid by $690,000.

"We've got data in EMR's and EHR's, clinical data, lab data, pharmaceutical data, images...data is everywhere.  But in many cases it's not connected, not sharable and our ability to link that data to individuals is limited.  We have to connect those dots.

Mark Boxer, EVP and CIO, CIGNA