A top priority of BHCG and its member employers is to purchase high value health care. To evaluate the quality and cost effectiveness of care provided by physicians throughout Wisconsin, BHCG commissioned two Physician Value Studies from Aitia, formerly GNS Healthcare, a leading provider of artificial intelligence and advanced data analytics methods in health care. A third iteration of the study is presently being conducted and results will be shared in 2025.

The studies draw upon data from the Wisconsin Health Information Organization (WHIO) which maintains Wisconsin’s All-Payer Claims Database (APCD), the state's most comprehensive source of health care data and information. It represents the majority of covered lives in the state, providing data and information to assess the quality, safety and cost-efficiency of health care delivered in the state.

Physician Value Study 1.0 in 2019 found profound levels of variability in both quality and cost-efficiency of physicians in the state. In 2021, BHCG commissioned Physician Value Study 2.0, again using WHIO’s extensive all-payer claims database with multiple years of data. The Study provided actionable results at an individual physician level. Key observation included the following:

  • There was almost no correlation between quality and cost-effectiveness of primary care physicians (PCPs)
  • There was substantial variation across specialists in the cost-effectiveness of care
  • Savings of over 26 percent or approximately $382 million ($325 million with PCPs and $57 million with specialists) of the $1.5 billion spent annually could be achieved by improving performance of both PCPs and specialists to the 50th percentile or higher; and/or through patient steerage.

Results of Physician Value Study 2.0 were used to:

Aitia
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