What is BHCG and why and when was it formed?
The Business Health Care Group grew out of the frustration felt by several CEOs of large Milwaukee-based employers concerning health care costs in southeast Wisconsin as compared to their other locations, particularly other areas in the Midwest.
A study commissioned by the Greater Milwaukee Business Foundation on Health found that in 2003, health care costs in southeast Wisconsin were 39 percent above the Midwest average. The founding CEOs realized that something needed to be done to support the economic viability of our area and maintain jobs in our market.
The CEOs also understood that no one employer was large enough to influence the health care market. It would take a number of large employers, speaking with one voice, walking in unison with a common strategy, to impact the costs of health care in southeast Wisconsin. Ultimately, 11 corporations with headquarters in southeast Wisconsin and two other existing coalitions founded the BHCG as a member-owned Limited Liability Corporation (LLC) in 2003 to explore alternatives to contain health care costs in the region. They soon established a goal to get costs at or below the Midwest average within five years.
The first step toward walking in unison was to select an administrator to allow the BHCG to have one voice in the market. In December of 2004 the BHCG selected Humana to be the sole administrator of its members’ affiliated health plans. Humana agreed to allow exclusive access to its high performance network, Humana Preferred, to the BHCG. In 2005 Humana re-contracted with providers on behalf of the BHCG and made the network available exclusively to BHCG employers on January 1, 2006.
In 2013 and 2014 the BHCG conducted an extensive strategic planning process. As a part of that process the BHCG assessed the strategic fit of its administrator with the BHCG's evolving strategic direction. After assessing capabilities and strategic fit of several administrators, it was determined that UnitedHealthcare would best serve the BHCG and its members. As of January 1, 2016 UnitedHealthcare became the BHCG's sole administrative partner, replacing Humana.
BHCG Mission statement
The Business Health Care Group leverages member employer purchasing power and knowledge to lead change. We create value through innovative shared strategies to improve health care quality and cost efficiency for employers, employees and the community.
More information about BHCG and its mission is available on this site.
What is the BHCG's service area?
The BHCG service area has now expanded beyond the original 11 counties in southeast Wisconsin -- Dodge, Jefferson, Kenosha, Milwaukee, Ozaukee, Racine, Sheboygan, Rock, Walworth, Washington and Waukesha -- to include an additional 11 counties in northeast Wisconsin. These counties include: Brown, Calumet, Door, Fond du Lac, Green Lake, Kewaunee, Manitowoc, Outagamie, Waupaca, Waushara and Winnebago.
What are the BHCG's core principles?
Several core principles, established during our formation, continue to serve us well in advancing our mission:
- Accountability from all stakeholders including health care consumers, health care providers, employers and our health plan administrator, UnitedHealthcare.
- A network strategy which promotes competition among providers to deliver quality, cost-effective care.
- Education of both employers and their employees. Employees must be motivated through plan design and education to become better consumers of health care. Employers must dedicate resources to educate their plan members.
Who are the members of the BHCG?
The BHCG is a membership organization of large and small employers throughout eastern Wisconsin. A complete list of BHCG members is available on this site.
Is BHCG just for large employers?
The BHCG is committed to expanding its membership to other like-minded employers and organizations. Employers of all sizes are eligible to join the BHCG, either as individual employer members or associate members. Chambers of Commerce and business associations can join the BHCG as sponsoring organizations.
The BHCG’s commitment to smaller employers is evident in the fact that UnitedHealthcare makes available a fully insured product for fully insured BHCG members. Fully insured employers with as few as two employees are welcome to join the BHCG.
What is the difference between an individual company member and an associate member?
Employers with 400 or more eligible employees, are self funded and make a capital contribution upon joining may join the BHCG independently as a Member. Individual Members may participate in all BHCG meetings and activities and have a voting right if they offer the UnitedHealthcare network to their employees.
Employers with less than 400 eligible employees that join independently or through a BHCG sponsoring organization or those with over 400 eligible employees that join through a BHCG sponsoring organization such as a chamber of commerce or business association are considered an Associate Member. Associate Members do not have a BHCG voting right but do have access to the UnitedHealthcare network as well as information, educational materials, preferred contractual vendor pricing and member meetings as determined by the Executive Steering Committee.
If an associate member joins through one of the BHCG sponsoring organizations, the sponsoring organization will pay the one-time joining fee for their members. Associate members who join the BHCG through a sponsoring organization pay only the annual, per-employee membership fees.
Who are the BHCG's strategic partners?
The BHCG is committed to promoting the evaluation, measurement and sharing of information on health care quality as part of its ongoing support of health care consumerism. In addition to our administrative partner, UnitedHealthcare, BHCG is actively involved in several statewide organizations, including the Wisconsin Collaborative for Healthcare Quality (WCHQ), the Wisconsin Health Information Organization (WHIO), the Partnership for Healthcare Payment Reform (PHPR), and the Wisconsin Statewide Health Information Network (WISHIN). These organizations spearhead quality of care measurement and reporting and information sharing in Wisconsin.
How are you holding providers accountable for helping to control health care costs?
The BHCG asks all providers to be accountable for their role in controlling health care costs. Providers are accountable for quality of the care delivered, complying with medical best practices, for appropriate resource utilization, controlling their cost structures, providing prospective pricing and supporting information transparency.
The BHCG, working with UnitedHealthcare, encourages consumers to seek care from providers that UnitedHealthcare has designated as providing high quality, cost effective care.
What are you doing to expand health care information available to consumers?
The BHCG believes information transparency is an important part of the foundation of the market-driven health care delivery system we are seeking to create in eastern Wisconsin. We work with UnitedHealthcare to offer health care cost and quality information and also support the efforts to make this type of information available to the public.
Through our partnership with UnitedHealthcare, consumers have access to myHealthcare Cost Estimator, a website with easy to use tools that compare both the cost and quality of health care providers. It uses estimates based on actual contracted rates. The information is also personalized to calculate estimated out-of-pocket expenses.
The BHCG also strongly encourages all network providers to become members of the Wisconsin Collaborative for Healthcare Quality to share best practices with other providers and publicly report their quality performance for consumers to access.
BHCG also is supportive of the Wisconsin Health Information Organization (WHIO), a partnership of health insurers, hospitals, doctors and employers that analyzes millions of health insurance claims to assess which doctors and hospitals are the most efficient.
What is the UnitedHealthcare network offering for the BHCG?
UnitedHealthcare offers a broad provider network throughout the BHCG service area. With in that network, employers have access to the UnitedHealth Premium® Designation program designed to assist consumers in selecting high quality, efficient health care providers. By using UnitedHealth Premium Tier 1 physicians, consumers can save money and be assured they are seeing a physician recognized for delivering higher value in health care.
What are some additional benefits of UnitedHealthcare?
BHCG members using UnitedHealthcare have:
- A member portal, through myuhc.com which includes online tools with efficiency and effectiveness indicators to help health care purchasers make informed decisions about the providers they choose for health care services.
- Access to a broad network of providers, including the best-known hospitals and health systems in the area.
- Customer service provided by a BHCG-dedicated, Wisconsin-based UnitedHealthcare team of specially trained billing, enrollment, claims and customer service representatives along with a dedicated 800 number focused exclusively on UnitedHealthcare health plan members.
How is UnitedHealthcare network different from other health plans?
In an era when provider networks are becoming more and more narrow, UnitedHealthcare offers a broad provider network offering consumers an extensive choice of providers. BHCG understands that not every health system or provider group is proficient at everything. A broad network allows consumers to see the provider of their choice regardless of health care system.
Coupled with its broad network, UnitedHealthcare has developed their UnitedHealth Premium® Designation program which identifies providers that have been recognized for delivering quality, cost-efficient care. Consumers can save money when they make more informed decisions about the providers they choose.
The employer community is the driving force in supporting these health plan offerings which are designed to control health care cost trend for employers and their employees by promoting consumer engagement, open access to provider price and performance information, and improved efficiency and effectiveness in the delivery of health care services.