world of health care we'll have a good conversation about that and but before we do it like our audience to get to know you a little bit i know you've had an extensive background and both government politics and public affairs tom currently serves as the director public affairs at horizon and horizon is state's largest and most experienced health insurer he oversees all of the public relations the media relations social media and is part of a large team responsible for the crafting corps then and executing horizons communication strategies his background also is he served as a communications consultant to the campaign of new jersey governor christie and as chairman of the new jersey republican state committee before his election to service chairman of the republican party was a partner in a successful public affairs from that was based in trenton and represented many various individuals as well as trade associations and he has a very variety why background  serves on the board of trustees that raritan value of the car which has been a lecturer in the world of higher education both records and writer and has also been very active in leading internships seminar at either end up in new brunswick and have it's great to have you here that said before and as the director of public affairs maybe you could tell us a little bit about the types of projects and initiatives that you oversee and get involved with on a daily basis sure so horizon as you mention it's the state's largest and oldest health insurance company where the only health insurance company is based in new jersey eighty four years based out of new work forever so with that we cover about three point nine million new jerseyans kariya horizon blue cross blue shield card in one form or another some of them are employer sponsored plans where they carry the the insurance some of them we serve self the state health benefits plan which covers state employees and schoolteachers  retirees medicare medicaid three point nine million almost half of the adults in new jersey so we are very involved in very active in a big footprint here in new jersey of about five thousand please twelve billion dollar company if we  fortune five hundred company would be in the top hundred but most importantly we're not for profit we operate in a one percent margin so unlike some other insurance companies where they have investors to pay they have stockholders to pay we are a publicly created entity eighty four years ago that allows us to operate on a one percent operating margin so when other very profitable entity because we pour back our resources into the products we deliver and to the community we serve so what do i do i help tell that story everything from dealing with reporters to programs like this to running our social media platform we have a great facebook and twitter footprint to finding ways to tell the horizon story we are  are a long deep proud new jersey company and so it's fun the fun to help them tell that's henri there's a lot going on in health care it's changing rapidly a lot of changes transitioning you see consolidation of health practices you see different surance products and it's a tough time to be a consumer you know where it is a much much more active buyer of health care than you ever were before so we're going to try to help make that a little bit more understandable and a little bit easier for people and then there's a lot of perceptions as well as misconceptions about health care and one of some of the ones that you run into the most commonly these days you know a couple things one is and i did touch on it that you know there's a lot of finger pointing you know who's to use to blame for the high cost of health care and let's face it health care costs a lot in new jersey it's the second most expensive place for health care in america which means it's really the second most expensive place for health care in the world which could mean it's second most of us right here in the universe but so it's really expensive here we have a lot of specialists it's not a very efficient system it's not very coordinated patients and consumers have to figure out which doctor to see when and what insurance is is a reflection of that you know just like auto insurance cost more in new jersey because we're really densely populated state health insurance cost more in new jersey because we're really expensive state for health care so one of the misperceptions that i have to deal with  least for horizon where can that one percent operating margin means we're not we're not drawing a lot of profit off there is no nobody else to pay back we reinvested into the company and into the products we deliver for people is you know who's really making a killing  in health in health care and you know a lot of times it gets pointed to the insurers physicians hospitals the reality is we have a lot of inefficiency in the system and a lot of duplication repetitive tests to test and that's starting to shift we've done something very different and i think pretty exciting it's called the omni alliance we announced it about just about a year ago it is a collaboration with seven of the most more significant and what that was is the leaders of those groups sort of all agreed that we need to do better we can figure out a different way to deliver this and whereas for years we've sort of been acting like hatfields and mccoys we've decided to sit around the same table and be hadfield mccoy's and figure out how can we align that delivery system to be more efficient to be more customers focused more patient centered deliver higher quality outcomes and lower costs and change the incentive structure  used to be that doctors were only paid to order more tests do more procedures write more prescriptions and those costs just kept mounting up because that's the only way they were paid now turned it around and said how about we pay you to be more efficient and to keep people healthier so big things that cost a lot of money in the long run things like diabetes cholesterol smoking cessation being overweight all of those things are imminently preventable if we get to you  early enough it's much easier to prevent you from becoming hypertensive if we catch you when you're when you're early in the in this stage we can fix that and it's less way less expensive its bets a better experience for you know other example of give you is personalized medicine cancer care cancer is very expensive thing to treat it's very expensive for the payers but it's also very expensive for the family exact so huge toll quality of life for the individual but for the whole family if we can figure out how to you know the old cancer protocol was well if you had in cancer most of the people who had lung cancer responded to this particular protocol most of them so we would run you through it and you know four months later they would say well you're not most of the people so most the people who don't succeed the first time well if we try this they succeed then we run you through that another eight months would go by and that didn't work and it mounted up and you got sicker and sicker and more tired as these treatments took their toll and you now we can figure out a partner with organizations that can target that medicine and say ok what kind of cancer do you have and what is unique about you that we can we can learn that makes that allows us to look at how everybody who just like you who's had this cancer responded and give us a jump start on on that treatment plan that eliminates a whole lot of things that probably aren't going to work for you so on the it is about a ligning those interests about putting the patient back at the center of the the the treatment plan and really a novel concept again i almost look at is it going back i grew up my dad was a solo practice physician up in somerville new jersey and so i think about omni is the way he used to do medicine which was put the doctor back in charge of being the doctor again and stop with all the bickering and fighting between the insurance company the doctor or let's get our interest in line and put the patient back in the middle of the mix again to make house calls seeing a lot of the carriers simply unable to to make it work this is a marketplace they were used to dealing with what we saw was a lot of the individuals who are uninsured roughly twenty million americans who were not insure be very sick they to be more sick than the average general population and they've had pent up demand things that they haven't taken care of the single most important thing that i think anybody in your audience who is an individual and who needs to buy that coverage on the care should know is that there are enormous and very generous subsidies available to people who are purchasing on the exchange people who are parching individual federal government just released a study that something like forty thousand new jerseyans are eligible for coverage who aren't taking advantage of it are eligible for a subsidy towards their coverage we're not taking advantage of it eighty percent of the people who do have coverage through the exchange so that's we have about three hundred eighty three hundred forty thousand new jerseyans who have bought three she's eighty percent of them are already getting a subsidy so there's another forty thousand who could get subsidized care and it's our subsidized payment for their for their and that would bring the average monthly cost to them probably below one hundred dollars which is pretty inexpensive if you're if you've ever shopped for health insurance before and these are good plans these are not bare catastrophic bones traffic policies these are plans that were designed intended to really take care of the preventative care to help get you to a primary care doctor connect you to a system of care to help keep you well and treat whatever may be ailing you but to help keep you well it's not and to limit your out of pocket and deductibles and your expenses and things like that so you know people at november one shop around i mean the bad news is the marketplace has has not quite stabilized new jersey there were going to be six different companies competing for your business if you were an individual consumer and that's what would have really created a robust marketplace as we follow each other we don't want to be the only carrier we want lots of competition because competition creates innovation and it helps drive the cost for everybody down we're down to two will be horizon blue cross blue shield in america health will be the two carriers that are offering coverage because you change is we were looking at six we lost one chose not to enter the market at nine and three have withdrawn including a public co op which was created as part of the it started with a lot of a lot of public money to get them off the ground but there's a there are good options out there you know people need just you need to shop you need to ask questions we'll have lots of retail opportunities set up we'll have call cent we'll have walk in places you can go to the we've got a customer service center down in morristown you can go to one in wall will be set up at malls so so we can help people answer their questions and understand their coverage you know the biggest the two biggest drivers we know of a happy customer are price and we're going to be real good on price and and their access and understanding how to use their benefits that's the biggest that's the biggest piece is once you've got this insurance how do you to community based organizations that are working to prove the quality health of all new jersey residents i know right here in princeton the carter theater i received a ten thousand dollar grant to crease accessibility services for vision and hearing impaired persons so what types of grants do you were have been awarded there and you know who's eligible and maybe we can you know make that know so we started a foundation in two thousand and four again being a company that is you know we are new jersey we are it were as new jersey as bruce springsteen and the jersey devils so this is our home we don't do business anywhere else we care about new jersey we care about the health and well being of new jersey so that foundation was created so part of our one percent margin include sending money into a foundation every year so we started that two thousand and four we've spent in excess of forty million dollars in those twelve years forty five million i think in those twelve years supporting community organizations that are focused on health and wellness and the experience of being new jersey and everything from sponsoring the the five k race to a couple of very significant signature initiatives we do a lot of work with home front here in mercer county know princeton why for example as part of that organization is it focused on kids age there teen to three trying to get them really active and engaged in a healthy lifestyle everything from educational programs to sports activities we have a partnership with the red bulls where we bring kids from healthy you up to the training camp and running around all day and teaching great soccer skills that is a huge huge program for us we've spent i think it's something on the order of about ten million dollars investing in preventing child who be seeing all kinds of getting getting kids off to the to a healthy start for a healthy life long term we do a lot of work with boys and girls club in new jersey on something called beam which is brighter better breathing easier asthma management so it's it's an educational program that helps families understand how asthma occurs why it occurs how you treat it how do you minimize the impact on your life you have it so another part of that on top of that you know you mention that there is a host of other sort of grants everything from arts and theater and i think the grant with macarthur for example was to help them improve accessibility so people who are handicapped can get in and out of theater people have hearing impairment can hear things like that so they can enjoy that full experience of being a new jerseyan we are online see you can look us up the horizon blue dot com and then and then search for the foundation there's a link in there where you can understand how to apply for a grant and  kinds of things we're we're looking for and we do that on a rolling basis a lot of organizations only issue grants once a year we roll our foundation roles throughout the year and really works to try to connect all across the state with proud of is that we're a company that very much looks exactly like the state we serve and diversity is not something that we just toss around and think about what's in it while it is very much a part of who we are more than sixty percent of the folks who work at horizon are women for example we have a huge area that you mentioned latinas we also have gotten recognized by the department of defense for the work we do trying to place veterans in  positions we have been named by working mother magazine a top ten company for working mothers it is part of who we are we have a whole division that deals with it not just for our employees but for our supply chain as well we look at women in minority owned businesses we look at businesses that are owned by veterans we look at businesses that are owned by veterans who have suffered a service related injury and try to ensure that we are directing as much of our of our purchasing power into those firms so that we can help grow the economy of new jersey with those kinds of businesses that are doing it we've got affinity groups inside the company so those are employees organizations within the company that focus on you know where and as cultural opportunities social opportunities we have latino we have african american we have women we have l g b t q we have muslim affinity groups we spend a lot of time  internally as a company learning about each other why of the kind of a cool programs as a reverse mentoring program so we've got employees who come from different backgrounds who will then shadow a one of our senior executives for the purpose not of learning about the senior executive job but what's so that the senior executive can understand better what that person's life is like where the perspectives of that community comes from so whether they be so latino community someone from the algae do you really it's really helping to sensitize or senior leadership to sort of the cultural nuances and needs of different parts of the jersey community so it's it's something that we take very different foods but i'm also surrounded by people who i'm learning from every day not just professionally but personally about what their lives are like and where you know their families histories and their cultures and it's really cool no i think a lot of the employees also volunteer their time with local organizations we have so part of our philanthropic effort is not just a foundation that writes money but it's getting our employees engage in active in a couple of weeks will be  descending on a park in new york it's our home community so we do spend a lot of time trying to give back in reinvest in new york it's new york's three hundred fiftieth birthday this year it is so we invite everybody come on up to new york there's great things going on there you don't just have to come to the theater and princeton are already here there's great stuff going on in new york we're going to be descending on a park there to clean it up spruce it up add some more trees make it a little bit more livable for the community i think we've done about five thousand hours of  employees based service in unity's again everything from soup kitchens and food banks to park clean ups to assisting it races and special olympics and all those kinds of things and you know again you know  as a as a new jersey company that's been here for eighty four years we take a lot of pride in new jersey and we take a lot of ownership that in and considered part of our responsibility to help lift the community and make the state a better place and pretty much all the forms you can think of is great and you know we can that is are they that is will be the twenty third of october i think is a fear that are coming up so they're probably about one hundred of us out there digging holes and planting trees and picking up long term vision or even the short term vision of the company in the years to come i think our goal is always very simple we want to make sure that we can provide high quality affordable health coverage to as many people as possible  and you know health insurance is simply a tool it's an access it's a way to cover your expenses in the health system we want people to be healthy if we're all healthy all of our health insurance will go down because we'll be paying less for  expensive treatment as opposed to paying less for prevention the where things are moving as a so they think that we're kind of going backwards right where we're going to a time when you know  primary care doctor really had the time to spend with you to help you navigate through an increasingly complicated system and we've got all kinds of great things happening in health care whether they're pharmaceuticals whether they're surgical procedures we are we are going to live longer and a higher quality of life then than anybody who came before us but that that's comes with increasing challenges right figuring out how to navigate that system and make decisions about your own health and what's right for you or your family is getting arder you need a you need a helper you need a navigator you need someone who sits at the center of your health care experience and can help you navigate that right now the system pays the doctor even your primary care doctor for the tasks that tests that they that they conduct or the procedures that they conduct or the pills that they prescribe that's how they get paid we want to pay them for their time so that they can have the kind of conversation you and i are having about your health and what you what are you doing that's called patient centered care you know there is no diagnostic code today that you can put down for i spent half an hour talking to lou about this cholesterol issue he's been fighting with not that lou has a cholesterol issue anybody i'm just using that as an example i don't know whether he does or doesn't and that could be a legal for me to say if i did so i didn't but we want people to be able to have that experience and be able to have that conversation patient centered care is doing that it's also have any effect of lowering the cost of care you think of him spending more time it's got to cost more actually it doesn't it ends up costing less we've seen a reduction in for five years we've now been piloting a bunch of different models is really what we base the the payment on if you will or the reimbursement on and the better job a physician can do helping you get healthy more efficiently in a way that is good for you  the better rewarded they are quite simply and we've seen great progress we've seen hospital readmission rates plummet we've seen emergency room visits plummet we've seen almost a twenty percent increase in diabetics ability to manage their their long term health we've seen tremendous progress on improvement on outcomes for breast cancer patients or press pain or maternity episodes of care all those things are some are helping to sort of you know all have the have the benefit of lowering cost but principally leading to a healthier healthier person at the end is good so the question i would like to my guess is growing up you have any role models i have any role models growing up besides my dad and of besides later on in life i think i think ronald reagan was a little bit of a role model i dabbled in politics for the for all the years before this guy worked were i've been lucky enough to work for a lot of really really good people here in new jersey in politics and outside of politics and many of them i consider role models chuck i ty and was a former assembly speaker here and as someone who taught me an awful lot about the way you conduct yourself and you know in politics i think people get  a bad rap sometimes because it's always oh there's always this deal making and they're not they're dishonest and they're not straightforward chuck was a straightforward guy when people would walk it was office and say i really like your help with this he would tell me exactly where he stood told him  stood there and i always ended the conversation with i may not agree with you on this one i can't be with you on this and that doesn't mean i don't want to talk to you tomorrow about the next thing you have because we always have a next thing here so i've had a lot of a lot of folks who i think helped me be a little bit about the people who are around you and you can draw a lot of good feelings from a lot of personal enrichment facility and from from taking the time to give back and be part of the community so i try to do that it's good it's opportunity to if you choose to use a large group of the providers you can have low and no deductible policies in place they're very much focused on health and wellness upfront doesn't you know we would they've got complete full comprehensive access to our network they are the wave of the future they've been proven very popular and probably the way the wave of the future for the company great with tom thanks for comin