Measuring our success…

Highlights of BHCG’s 2014 Performance Scorecard

The 2014 Performance Scorecard is intended to identify how the BHCG as a group and Humana are performing compared to baseline measures and benchmarks. Some highlights from the Scorecard include:

Cost & Utilization

  • Medical costs per member per month for all self-funded groups – calculated prior to benefit application to eliminate the impact of benefit design changes – increased  3.9 percent from 2013 to 2014.
  • Over the past nine years the BHCG’s self-funded member employers have experienced an average annual increase in medical care costs of 2.5 percent per health member per month when compared with 2005 base-year costs. Over this same nine-year time frame, costs in southeast Wisconsin have increased on average between six and 10 percent per year.
  • In the past nine years, BHCG self-funded employers have saved approximately $1.17 billion when compared with the southeast Wisconsin’s market trend over the same period.
  • Utilization of in-network providers by employees and their dependents stood at 96.4 percent for fully insured employers and 97.3 percent for self-funded employers.
  • Total BHCG membership in the Humana Preferred Network increased 1.9 percent in 2014 compared to 2013.

Consumer Engagement

  • Member registration at in 2014 stood at 60 percent for self-funded employers and 50 percent for fully-insured employers, the same as in 2013.
  • Generic utilization of retail prescription drugs in 2014 increased from 80 to 81 percent for self-funded employers and remained at 82 percent for fully insured employers.
  • Generic utilization of mail-order prescription drugs in 2014 increased from 79 to 81 percent for self-funded employers and increased from 79 to 83 percent for fully insured employers.
  • In 2014, 36 percent of self-funded employers offered a consumer directed health plan (CDHP) (compared with 28 percent of Humana’s book of business), while 11 percent of fully insured employers offered a CDHP (compared with 24 percent of Humana’s book of business).

Humana Performance

  • Humana’s service unit met or exceeded all its 2014 performance goals for measures such as claims processing accuracy and turnaround time, telephone response time and call abandonment rates.

The BHCG’s Best Doctors results for Q1 2015

Best Doctors, the BHCG’s informed decision making vendor, recently reported its results for the first quarter of 2015 for BHCG self-funded employers.

The Best Doctors program offers consumers facing difficult medical decisions access to expert medical consultations in addition to a range of other tools and resources so they may have the confidence to make informed decisions about their care. Highlights of the results include:

  • Thirteen self-funded employers participated in the program
  • Diagnosis changes were made in 28 percent of the cases, while treatment recommendation changes were made in 50 percent of the cases
  • Contacts from members were evenly split between males and females – 50 percent each
  • 100 percent of survey respondents gave the highest rating for Best Doctors’ overall ability to meet their needs and would recommend Best Doctors to their co-workers

BHCG remains committed to assisting employees in becoming better health care consumers. The services of Best Doctors helps the BHCG and its employer members meet that commitment.

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