The Business Health Care Group grew out of the frustration felt by several CEOs of large Milwaukee-based employers in the early 2000s concerning health care costs in southeast Wisconsin as compared with their other business 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 CEOs realized that something needed to be done if the region was going to thrive economically and maintain jobs.
They 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 and utilizing a common strategy, to impact the costs of health care in southeast Wisconsin. Ultimately11 corporations with headquarters in southeast Wisconsin and two other existing coalitions founded BHCG in 2003 as a member-owned Limited Liability Corporation (LLC) to explore alternatives to contain health care costs in the region.
An Evolving Strategy
In January of 2005, BHCG selected Humana to be its medical plan administration partner. In this capacity, Humana was charged with developing a provider network (Humana Preferred) which was made available to member employers on January 1, 2006.
In 2013 a rigorous strategic planning process was initiated to assess how to maintain BHCG’s successful track record of bending the cost curve in its health care market. The process culminated in the decision to replace Humana with UnitedHealthcare, effective January 1, 2016, to offer an innovative health plan offering (using UnitedHealthcare's broad network) that best reflects BHCG's strategy of strengthening consumer and provider accountability.
In 2018 BHCG’s executive leadership, with assistance from outside experts, embarked on a strategic planning process to define the direction of the organization for the next three to five years. The strategic plan’s goal was to demonstrate responsible corporate citizenship by improving health care value for member employers, their employees and dependents, and the community at-large by identifying and contracting with best in class strategic partners.
As a result of this strategic planning process, BHCG chose to add Centivo to provide a high-performance health plan and claims administration, replacing UnitedHealthcare. Effective January 1, 2022, Centivo will offer this high-performance health plan which will include broad and narrow provider networks. It will feature fully transparent administrative services, efficient claims processing, advanced cost controls, employer analytics and integrated stop loss.
Centivo works with employers to direct patients to high value providers; encourages coordinated care through the use of a primary care physicians (PCP); fosters stronger relationships between patients and providers; offers more affordable and predictable costs; and provides a better health plan experience for employees, using clear language, concierge level phone support and plan education.
Today the BHCG primary service area includes 22 counties in eastern Wisconsin: Brown, Calumet, Dodge, Door, Fond du Lac, Green Lake, Jefferson, Kenosha, Kewaunee, Manitowoc, Milwaukee, Outagamie, Ozaukee, Racine, Rock, Sheboygan, Walworth, Washington, Waukesha, Waupaca, Waushara and Winnebago. Presently, employers and employer groups of all sizes, representing more than 200,000 lives, participate in BHCG.
In 2018 BHCG created additional membership opportunities for employers in its service area and nationwide. Reduced-fee standalone memberships are now available for employers to access BHCG’s contractual relationships with its best in class strategic partners.
The Power of Partnership
Integral to the BHCG value proposition is its ever-growing number of solutions to help employers more effectively manage their benefit programs. Working with best in class strategic partners, BHCG’s diverse portfolio of employer solutions in benefit delivery, advocacy and patient decision-making aligns with BHCG’s mission to improve health care value. Presently, BHCG's best in class strategic partners include:
- Centivo – high-performance health plan and claims administration
- Teladoc (formerly Best Doctors) – informed decision making
- Navitus Health Solutions – pharmacy benefit management
- Quantum Health – consumer navigation and care coordination
- Welldoc – diabetes management
BHCG’s Strategic Plan: Analytics + Informed Guidance = Increased Value
BHCG’s initiatives over the next three to five years will focus on two core elements that will have a significant impact on improving health care value:
- Analytics to identify high and low value providers and services; and
- Informed guidance to motivate patients to consume (and providers to supply) only necessary, high value services
Analytics: The analytics component is designed to identify high value providers and to enter into dialogue with health systems about adopting more effective practice patterns and value-based pricing. BHCG and its strategic partners need to understand how and where the best care is delivered to support its mission to improve health care value.
Informed Guidance: Armed with data identifying high value providers, member employers can help individuals make good choices so they consume only necessary, high value services. Guidance can come from a number of different places, including its best in class strategic partners.
Discussions continue with other organizations to develop additional strategic partners, further adding to the value of BHCG membership.
Access a partial listing of BHCG member employers.