by Dianne Kiehl
Celebrating a milestone year
From the Executive Director

Two thousand thirteen marked the tenth anniversary of the Business Health Care Group’s formation which culminated in a celebration at our second annual public meeting held in September. The theme of the meeting was “Riding the Wave Together – 10 Years,” an accurate description of our mission and activities over the past decade. The change in our health care system is like a wave – we can ride the wave of change, always on top, deciding where we want to go, or we can get consumed by the wave of change with little opportunity or ability to determine where we end up.

We realized early in our existence that employers needed to unite as health care purchasers – none of us could go it alone. We needed to ride the wave together as employers and we needed to include providers, strategic partners, brokers and consultants, consumers and our administrative partner, Humana.

Outperforming the market

Thanks to this collaborative effort, we have made remarkable progress in slowing health care cost increases for our members, continuing to outperform the market as shown in BHCG's costs results:

  • BHCG costs results for 2011 (the most recent data available) were 11 percent below those for southeast Wisconsin; four percent below the Midwest average and six percent below the national average.
  • BHCG self-funded employer costs decreased by an average of 2.6 percent from 2011 to 2012 and have only increased an average of 1.6 percent annually since inception of the network compared with average market increases of anywhere from 7-10 percent annually.

Measured another way, BHCG self-funded employers have saved approximately $773 million since the BHCG network (Humana Preferred) has been in place. These are truly results to be celebrated, however there is still much work to be done. For example, the BHCG recently renegotiated its pharmacy contract after an evaluation and market assessment found opportunities for improvement. It is estimated the new contract (beginning on January 1, 2014) will save nearly $4 million for self-funded employers. We continue to look for ways to advance our mission and undertake projects that will have the most value for our employer members and also impact the value of health care delivered in southeast Wisconsin.

Engaging consumers

We are also committed to engaging consumers in their own health and health care decisions – and in 2013 our major initiatives reflected that commitment. Last year we selected Best Doctors® as our informed decision making vendor as part of our long-term consumer engagement strategy. Today more than 45,000 employees (from self-funded and fully insured employers) have access to the Best Doctors program, with others scheduled to implement the program on January 1, 2014. We now have some very impressive results from our first six months of experience with Best Doctors.

In terms of utilization, Best Doctors received 359 calls from BHCG members’ employees or their dependents and the clinical impact of the program has been significant thus far. In more than half of the cases that involved expert medical consultation (51 percent), the initial diagnosis was found to be inaccurate and was changed. In 81 percent of these cases, the treatment recommendations were other than what was originally recommended. We believe this program is an important differentiator for us in the marketplace and another compelling reason for employers to consider BHCG membership and the Humana Preferred offering.

In another initiative designed to help consumers make well-informed decisions about their wishes for the end of life, the Wisconsin Medical Society launched a major project in 2013 called Honoring Choices Wisconsin to promote the benefit of advance care planning across the state. The project’s goal is to have a standard community approach to ensure patients make the end of life decisions they wish and communicate them with the appropriate people. The BHCG strongly endorses and supports this initiative by encouraging our local providers to participate.

Advancing and supporting membership

We also made a concerted effort this year to communicate our value proposition – to both our existing membership and their employees and to those employers who have yet to join the BHCG. We developed a quick, easy-to-read piece that outlines the key benefits of BHCG membership which include the array of programs, initiatives, events and resources designed to help employers get the most value for the dollars they spend on health care benefits.

A similar piece was created for employees that employers can use to educate their employees about the BHCG and why they are involved and also how the BHCG supports them as health care consumers. The document is available on the Web2Print section of the BHCG website and can be personalized to meet employers’ specific communication needs.

Informing and educating membership is also a primary goal of our organization and in 2103 we published nine editions of our newsletters (The Catalyst & Monitor) to keep members, providers, our strategic partners and brokers and consultants abreast of BHCG activities and the industry in general, including health care reform. We continue to be a source of information regarding ACA implementation via Monitor articles and through the access we provide to the latest health care reform information found on The Alliance (the business health care coalition in the Madison area) website.

Looking forward to 2014

Our plate is already full for 2014 as we work to continue to drive meaningful change in our marketplace together. That includes supporting the great work that’s being done by our strategic partners – the state’s leading health care organizations such as the Wisconsin Collaborative for Healthcare Quality, Wisconsin Health Information Organization, Partnership for Healthcare Payment Reform, Statewide Value Committee and Wisconsin Statewide Health Information Network (whose boards I participate on). We will also spend time on several projects begun in 2013, such as:

  • QualityPath – A major initiative in collaboration with The Alliance whose goal is to determine levels of variation in quality of health care for specific elective procedures at both the physician and facility level.
  • Behavioral Screening & Intervention – A project to encourage the provider community to engage in behavioral screening and intervention as a standard of care to begin to affect the impact of behavioral health issues on health care costs, productivity, workers’ compensation and disability claims.

We will continue to keep our focus on working with providers to improve the value of health care delivered in our market in the coming year – along with the help of our strategic partners and other stakeholders, as well as our administrator, Humana. We will also support you in your efforts to implement the ACA while we navigate the changing health care landscape together. I look forward to working with you in 2014 and wish all of you the happiest of holidays and a successful and healthy New Year!

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