Membership Opportunities
Employers — both large and small — are welcome to join BHCG.
BHCG leverages member employer purchasing power and knowledge to lead change. The organization creates value through innovative, shared strategies to improve health care quality and cost efficiency for employers, employees and their dependents and the community. BHCG holds in high regard its partnerships with health care systems and provider groups in these efforts. BHCG membership is available in Wisconsin and nationwide for employers accessing BHCG's best in class strategic partner solutions.
Membership Growth
Membership grew significantly throughout 2023, both in terms of employers becoming members of BHCG and employers offering the BHCG-Centivo high-performance health plan solution to their employees. As of January 1, 2024, membership in the high-performance health plan increased 85 percent compared to January 1, 2023. Strong sales throughout 2024 are anticipated.
BHCG-Centivo High-Performance Health Plan Yields Outstanding Results for BHCG Member Employers, their Employees and Dependents
2023 marked the second year BHCG member employers offered the BHCG-Centivo high-performance, primary care-centered health plan to their employees. Again, this year the innovative primary care physician-guided model yielded outstanding results and satisfaction for member employers, their employees and dependents. Employers and health plan members saved 18% compared with a nationally recognized benchmark.
Centivo’s High-Performance 2023 Health Plan Results in Wisconsin versus Industry Benchmarks
Metric |
Centivo High-Performance Health Plan |
Nationally Recognized Benchmark for Mid-Size to Large Employers |
Percent Difference |
Total Medical Costs (per member, per month) |
$533.13 |
$649.21 |
-18 |
Primary Care Physician Visits (per 1,000 members) |
2,262 |
1,565 |
+45 |
Preventive Visits (per 1,000 members) |
818 |
628 |
+30 |
Inpatient Admits (per 1,000 members) |
47 |
56 |
-17 |
Emergency Room & Urgent Care Visits (per 1,000 members) |
264 |
376 |
-30 |
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, 2023, and included a reserve for claims incurred, but not yet reported or paid, by year-end.
Navitus Health Solutions – A Formula for Success
Navitus Health Solutions, BHCG’s best in class strategic partner for pharmacy benefit management, recently released their 2023 Drug Trend Report. As in past years, the 2023 report demonstrates how Navitus is outperforming the PBM industry on several key metrics for all its clients:
- Commercial clients saw a 6.8% average increase in Net Total Cost¹ PMPM trend from 2022 to 2023
- Despite notable increases in unit cost and utilization 29% of Navitus commercial clients saw their net drug spend decrease compared to 2022
- Decreased unit costs (-4.9%) helped to manage total specialty trend to a modest 5.7% PMPM increase for commercial clients as utilization trend increased more than 10%
- New clients saw an average 11% reduction in Rx costs compared to the previous year with a different PBM.
2023 Key Statistics for BHCG Member Employers
BHCG member employers saw a similar strong performance from Navitus in managing their pharmacy benefits in 2023. In aggregate, member employers:
- Had a Net Total Plan Paid PMPM increase of 5.3%
- Thirty-eight % of member employers had a negative trend from 2022 to 2023.
- Member employers spent an average of $64.56 PMPM on pharmacy benefits with their previous PBMs in 2018. These same clients paid $65.06 in 2023 (less than a 1% increase) in Net Plan Cost PMPM over the course of five years.
- In aggregate, member employers received over $13 million in rebates in 2023. Through the 100% pass-through model, this is $1 million+ more than if contracts were limited to guaranteed rebate amounts.
City of Kenosha Continues to Control Pharmacy Spend
In 2018, the city of Kenosha, Wisconsin (with 900 employees and approximately 2,400 plan members) looked to replace its existing pharmacy benefits manager due to unsustainable cost increases. The City implemented BHCG’s best in class strategic partner Navitus Health Solutions on January 1, 2019, taking advantage of BHCG’s preferred contract rates and terms – and the results have been outstanding.
- In the first five years with Navitus as its pharmacy benefit manager, the city has saved more than $4.3 million
- Because of Navitus’ 100 % pass through of rebates and pharmacy discounts, the City’s rebates increased by 408% from 2018 to 2023
- Net plan cost Per Member Per Month (PMPM) decreased by 38% from 2018 to 2023
- Due to Navitus’ clinically driven formulary management, total plan costs (before rebates) decreased by 8% from 2018 to 2023
¹ Net total cost includes total cost paid by plans and members minus manufacturer rebates