Measuring our success…

Best Doctors reports results for first six months of 2013

Last year the BHCG selected Best Doctors of Boston as its informed decision making vendor to help employees make more informed health care decisions. Best Doctors offers BHCG members’ employees and dependents several services including:

  • InterConsultation Service – provides an expert medical consultation with a nationally renowned physician to confirm a diagnosis and treatment plan. The service uses the top physicians in the country who collaborate with the treating physician to ensure the best possible care is being delivered .
  • Ask the Expert – access to expert physicians for non-emergencies when a diagnosis is confirmed but questions remain regarding a treatment plan.
  • Explore My Options – includes clinical coaching and on-line decision aids for members facing surgery, to determine if less invasive treatment options are appropriate.
  • FindBestDoc Service – connects members with the right in-network expert specialist or subspecialist for their conditions.

The Best Doctors program became available for self-funded member employers on September 1, 2012, with several member companies acting as early adopters. Presently, 16 self-funded BHCG employers have implemented the program, with one more set to join the program on January 1, 2014. On January 1, 2013 Humana implemented the program for all its BHCG fully insured employer groups. As of today, more than 45,000 employees have access to the Best Doctors program.

Results for the first six months of 2013 demonstrate Best Doctors had made a significant impact in the lives of some of our members’ employees. During this timeframe:

  • Best Doctors received 359 calls from BHCG members.
  • For InterConsultation Service cases, a diagnosis change occurred in 51 percent of the cases, while a treatment change was recommended in 81 percent of the cases.

BHCG employers will save millions in renewal of pharmacy contract with Humana

Based on an evaluation of the competitiveness of the BHCG’s current prescription drug benefit contract with Humana for self-funded members, the BHCG recently renegotiated the pharmacy contract. The evaluation and market assessment of current market pricing completed in November 2012 found opportunities for improvement in the following pricing areas:

  • Retail dispensing fees
  • Retail discounts for brand and generic drugs
  • Mail discounts for brand drugs
  • Rebate guarantees

It is estimated the new contract, commencing January 1, 2014 and running through the end of 2015, will save nearly $4 million for self-funded employers. In addition, Humana offered early pricing improvements for the last quarter of 2013, with a projected additional savings of $260,000 for October 1 – December 31, 2013.

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