OUR LEADERSHIP

HORIZON Health Ventures is led by individuals who bring unique perspectives and cutting-edge ideas to the management of health care.

Representing disciplines from health care cost management, benefits administration, data analytics, account management and consumer satisfaction, we have over 100 years of successful business and healthcare experience.

Cory
Easton
Principal - HORIZON Health Ventures, LLC
Cory Easton has over 30 years experience in health care cost management. Cory spent 10 years working in Population Health Management at Intracorp and for more than 17 years held various positions at Express Scripts, Read More
Cathy
Addis
Vice President, Account Management
Cathy Addis has over 20 years of industry experience in account management, client implementation, and employee benefits. Prior to joining HORIZON Health Ventures, Cathy worked for a broker organization for over 6 years as a Senior Read More
Peter
Morgan
Account Management
Peter has worked in the PBM industry for the last 20 years, all in Account Management including 18 years with Express Scripts. Prior to working in PBM, Peter worked for 5 years in Account Management Read More
Tricia
Wilson
Director of Marketing & Communications
Tricia has over 25 years of experience as a marketing and communications professional. She started her career at CareFirst BlueCross BlueShield of Maryland where she gained a wide variety of experience, taught herself graphic design Read More
Anthony (AJ)
Somaini
PharmD. RPH
Senior Clinical Consultant, Performance Pharmacy Solutions
AJ has over seven years of direct patient care experience in multiple pharmacy practice settings.  Before coming to HORIZON Health Ventures, he practiced as a Licensed Pharmacist and Clinical Liaison with Rite Aid Pharmacy.  AJ Read More
Phil
Valk
Vice President of Sales - Advanced Medical Pricing Solutions (AMPS)
Phil Valk is a healthcare cost management expert and currently serves as Vice President of Sales with Advanced Medical Pricing Solutions (AMPS).  As a trusted advisor and service partner to HORIZON Health Ventures, Phil is Read More
Robert
McCord
Regional Director, Sales
Bob has over 30 years experience in healthcare management. During his career, Bob has held senior level positions with companies such as MetLife, Principal Financial Group, Coventry Health Care, Health Partners and NCAS (TPA subsidiary of Read More
Bill
Lenskold
Regional Director, Sales, Performance Pharmacy Solutions
Bill brings more than 25 years of sales and marketing experience in the group insurance industry to PPS.  He started his insurance career as a group underwriter and spent time in the brokerage marketing area Read More
Arlene
Romaska
Consultant, Data Analytics
Arlene began her data analytics career in 2001 after serving 8 years on Active Duty in the United States Air Force.  She transitioned to the employee benefits industry in 2008 as a Benefit Analyst with Read More
Matt
O'Neal
Sales Operations Manager
Matt O’Neal has over 8 years of experience in the Healthcare industry. He began his career in healthcare at Express Scripts where he held various positions within Sales and Underwriting. This broad range of experience Read More
Avi
Pelta
Regional Sales Manager
Avi has over 40 years experience in retail pharmacy. Prior to owning his own pharmacy in Baltimore Maryland for the last 29 years, he has managed and supervised a group of pharmacies in both retail Read More
Olivia
Hancock
Account Executive
Olivia has over 15 years of healthcare experience in account management, client implementation, and benefit consultation. She started her career at Anthem as a reporting analyst for actuarial reporting. Prior to joining Horizon, Olivia worked Read More
Helen
Hennessy
Helen has over 25 years of healthcare experience in the pharmacy industry. Prior to joining PPS, Helen worked at Express Scripts for over 20 years in Account Management.  Realizing that each client had its own Read More

 

LATEST
NEWS


Today's blog features the Benefits Pro article that highlights the proposed delays for Obamacare health taxes. Natasha Rausch writes that the measures proposed in the...

Today's blog features the Modern HealthCare article that highlights that starting February 1st Blue Cross will be limiting opioid prescriptions to members to 30 days,...

Today's blog features a powerful video published by Express Scripts that highlights the continued opioid crisis. Express Scripts is determined to make the use of...
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.

"At HORIZON Health Ventures we introduce and implement integrated management strategies that heighten the quality of healthcare received by our clients while returning a positive financial outcome to our plan sponsors, stakeholders and vendor partners.