In 2003 a study sponsored by the Greater Milwaukee Business Foundation on Health (GMBFH) found health care costs in southeast Wisconsin were 39 percent above the Midwest average. This was the impetus for the CEOs of some of the area’s largest employers to form the Business Health Care Group (BHCG) that same year. It was clear this disparity in health care costs could not continue if southeast Wisconsin’s employers were to compete on a national and international basis.

Since that time BHCG has made remarkable progress in slowing health care cost trend for member employers and the community in general, making our region a more competitive health care marketplace. That progress continued in 2022 when numerous BHCG member employers adopted the BHCG-Centivo high-performance, primary care-centered health plan, the culmination of BHCG’s efforts to improve health care value – both costs and quality.

Changes in how plan members sought out and accessed medical services through the BHCG-Centivo high-performance, primary care-centered health plan solution resulted in significant savings for BHCG member employers and their health plan members. Wisconsin BHCG member employers saved 23 percent compared to a nationally recognized industry benchmark, while their employees paid an average of $700 per year in annual out-of-pocket costs, compared to the national average of more than $1,650. This strong primary care physician-guided model is leading to long-term sustained cost savings for employers as plan members access more appropriate and preventive care.

BHCG-Centivo’s High-Performance Health Plan Results in Wisconsin versus Industry Benchmarks*

Metric Centivo High-Performance Health Plan National Recognized Benchmark
(Moderately Managed)		 Percent Difference National Recognized Benchmark
(Loosely Managed)		 Percent Difference
Total Medical Costs
(per member, per month)		 $350.72 $455.88 -23 $548.31 -36
Primary Care Physician Visits
(per 1,000 members)		 1,745.3 1,297 +35 1,351.5 +29.1
Specialist Visits
(per 1,000 members)		 907.5 790.5 +15 793.5 +14.4
Inpatient Admits
(per 1,000 members)		 40.9 44.4 -8 49.4 -17.2
Emergency Room Visits
(per 1,000 members)		 100.3 120.6 -17 144.7 -30.6
*Centivo's analysis is based on claims from Wisconsin-based members enrolled in the Company's High-Performance Health Plan incurred from Jan.1 through Dec. 31, 2022, and include a reserve for claims incurred, but not yet reported or paid, by year-end.

Centivo’s 2022 results clearly demonstrate its primary care physician-centered model has influenced how plan members engage with their health plan benefits – leading to less inappropriate spending, enhanced decision-making and an overall better health care experience.