By the Numbers
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 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.
Centivo – High-Performance Health Plan Yields Outstanding Results for BHCG Member Employers, their Employees and Dependents
2022 marked the first year BHCG member employers offered the BHCG-Centivo high-performance, primary care-centered health plan to their employees. This innovative primary care physician-guided model has yielded outstanding results and satisfaction for member employers, their employees and dependents. Employers and health plan members saved 23 to 36 percent compared with nationally recognized benchmarks.
Centivo’s High-Performance Health Plan Results in Wisconsin versus Industry Benchmarks
Metric |
Centivo High-Performance Health Plan |
Nationally Recognized Benchmark |
Percent Difference |
Nationally Recognized Benchmark |
Percent Difference |
Total Medical Costs |
$350.72 |
$455.88 |
-23 |
$548.31 |
-36 |
Primary Care Physician Visits |
1,745 |
1,297 |
+35 |
1,352 |
+29 |
Specialist Visits |
908 |
791 |
+15 |
794 |
+14 |
Inpatient Admits |
41 |
44 |
-8 |
49 |
-17 |
Emergency Room Visits |
100 |
121 |
-17 |
145 |
-31 |
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, 2022, 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’ unique approach to pharmacy benefit management combines financial performance, demonstrated service and clinical excellence with a 100 percent pass-through business model that aligns incentives with the best interests of our member employers.
Navitus has proven to be a game changer for member employers. Using its administrative fee only model featuring complete transparency, unbiased formulary recommendations and lowest net cost, Navitus has produced superior cost savings.
2022 Key Statistics for Navitus’ Book of Business
- Commercial clients saw just a 2.6 percent average increase in Net Total Cost¹PMPM trend from 2021 to 2022
- Forty-nine percent of Navitus commercial clients saw their net drug spend decrease compared to 2021
-
Decreased unit costs helped to manage total specialty trend to a modest 3 percent PMPM increase for commercial clients
- Modest utilization growth (1.7 percent) in the non-specialty space, offset by a reduction in unit cost (-2.6 percent), led to a negative overall PMPM trend (-.9 percent) in 2022.
¹Net total cost includes total cost paid by plans and members minus manufacturer rebates
2022 Key Statistics for BHCG Member Employers
- In aggregate, member employers had a Net Total Cost PMPM decrease of 1.7%. — nine clients had a negative trend
- BHCG member employers received more than $64 million in rebates which was $152,000+ more than they would have received had their contract limited the rebates strictly to the guaranteed rebate amount.
City of Kenosha Gains Control of 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 four years with Navitus as its pharmacy benefit manager, the City has saved more than $3.3 million
- Because of Navitus’ 100 percent pass through of rebates and pharmacy discounts, the City’s rebates increased by 296 percent from 2018 to 2022
- Net plan cost Per Member Per Month (PMPM) decreased by 46 percent from 2018 to 2022
- Due to Navitus’ clinically driven formulary management, total plan costs (before rebates) decreased by 22 percent from 2018 to 2022.