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You’re Paying a High Price
One way or another, we’ve all felt the pain of high health care costs. Even if you haven’t had big medical bills yourself, you’ve shared the cost in other ways. For instance, many employees have felt the impact through:
- Larger increases in employee premium contributions.
- Rising deductibles.
- Paying more in plan coinsurance (the percentage of medical costs that you pay).
- Financial penalties for non-emergency visits to the ER or name brand drugs.
- Elimination of some plan options or networks.
- Extra charges to cover a spouse under your employer’s plan.
- Less access to coverage when you retiree, because many employers can’t afford to offer it.
- Lower pay raises.
- Fewer local job opportunities, because some employers have moved jobs to areas with lower health care costs.
- Higher prices for everyday things you buy, because businesses are charging more in order to pay for their employees’ health care.
BHCG and Your Employer: Working for Solutions
Health care costs in southeast Wisconsin, while still generally higher than the national average, have risen at a lower rate recently. The Business Health Care Group (BHCG) has played a role in slowing the increases in health care costs in our area.
BHCG is a group made up of hundreds of employers, large and small, throughout southeastern Wisconsin. Rather than sit back and watch heath care costs get completely out of control, these employers have joined forces to tackle the problem head on. We like to think of it as "employers walking in unison."
BHCG: Working for Change
BHCG’s goal is to "drive meaningful change in the health care marketplace." In short: BHCG is working to change the way health care is used, delivered, managed and paid for – all of which can help save money for people and employers while maintaining, and even improving, quality.
To bring about these changes, BHCG has developed a comprehensive strategy that:
- Supports consumers of health care by providing information on health care pricing and provider performance (see the section below: The UnitedHealthcare Provider Network)
- Leverages purchasing power
- Encourages accountability of providers and consumers
BHCG’s strategy rests on an important first step — consolidating plan administration to improve efficiency. Selecting UnitedHealthcare to administer member employer's health plans has allowed us to:
- Leverage our purchasing
- Create the needed information transparency
- Improve accountability, and
- Provide consumers - employees and their families - access to the resources they need to become educated purchasers of health care
Focusing on Quality
BHCG also works to improve health care quality. Regularly, BHCG meets with local health care providers to discuss ideas for quality improvement. In addition, BHCG works closely with many local and national groups focused on quality health care outcomes, such as:
- Wisconsin Collaborative for Healthcare Quality (WCHQ)
- Wisconsin Health Information Organization (WHIO)
- National Alliance of Healthcare Purchasing Coalitions
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Buyer’s Guide to Health Care
Watching these online video modules is an entertaining way to become a better consumer. Start anywhere you like...
- Module 1: Meet Joe, a Health Care Consumer. Why you need to pay attention to what’s happening in the health care market – there’s a lot at stake!
- Module 2: How Insurance Works. Who pays… when… and how much – including tips for understanding all the paperwork.
- Module 3: Right Plan, Right Doctor. How to make smart decisions when choosing a medical plan and a doctor.
- Module 4: Getting the Most from Your Health Care Visit. Learn what questions to ask, and tips for speaking up and partnering with your doctor.
- Module 5: Going to the Hospital. Things you do to help ensure a healthy outcome.
- Module 6: Prescription Drugs. You have more options than you might think, and the cost varies a lot.
- Module 7: Prevention and Lifestyle. Many health problems – and the cost of treating them – could be avoided through changes in everyday behaviors.
- Module 8: The BHCG’s Role. Why your employer joined BHCG, and what’s in it for you.
Participants in UnitedHealthcare plans can also take advantage of myuhc.com. Registering at this personalized web site lets you take advantage of interactive tools, health care quality information, pricing information, a confidential health assessment, healthy lifestyle programs and much more.
More BHCG Resources
As part of its mission to drive meaningful change in health care, the Business Health Care Group website offers links to many consumer resources.
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Early on, the member employers of BHCG made the decision to consolidate the benefits administration to a single vendor (in other words, select one insurance company to process claims). Having one benefits administrator supports BHCG’s overall strategy, because it:
- Is more efficient;
- Gives BHCG members more leverage in negotiating prices and services;
- Simplifies data collection, for better analysis;
- Ensures a consistent message to providers and consumers; and
- Fosters true partnerships with our administrator, UnitedHealthcare, and the providers.
BHCG chose UnitedHealthcare as its administrative partner. UnitedHealthcare is the best fit to work closely with BHCG members to "drive meaningful change" in health care.
The UnitedHealthcare Provider Network
UnitedHealthcare has developed a broad network of health care providers in southeast Wisconsin. The network includes virtually all medical specialties and all the major health care systems in the region. In addition to the broad network, UnitedHealthcare has developed its UnitedHealth Premium® designation program. The Premium program is one of the longest-running physician quality and cost-efficiency designation programs in the industry.
The Premium designation program evaluates doctors using national standards for quality and local benchmarks for cost-efficiency. Tier 1 physicians, in 27 different medical specialties, are recognized for meeting national standards for quality and local benchmarks for cost efficiency.
UnitedHealthcare shares this information with you to help you make informed choices about your care. Depending on your plan, your co-pays and/or deductibles may be less when you see a Tier 1 physician. Even if your plan pays the same whether you use a Tier 1 physician or not, you will typically pay less in the form of co-pays for the same service when using a Tier 1 physician since they were chosen based on both the quality and cost-efficiency of their practice.
When looking for a provider start by checking for the name of the plan you are enrolled in. You will find the plan name on the bottom-right corner of your member ID card. If you can't find or don't know the name of the plan your are enrolled in, please contact your employer.
"The plan my employer offers doesn't include my doctor. Now what?"
Some things to keep in mind:
- The makeup of any provider network - whether it's a UnitedHealthcare network or another insurance company's network - is subject to change. From time to time, doctors may leave or join the network. So it’s always worthwhile to check back with your doctor in case he or she has made changes to the provider networks they participate in. If your doctor is not in the network you are offered, you may want to switch to a doctor in your network in order to have your expenses covered at the highest level available under your health plan.
- We understand that changing doctors can be inconvenient, to say the least. While we would rather not disrupt anyone’s relationship with their current doctors, we believe that partnering with UnitedHealthcare is in the best interest of BHCG members. They offer a very broad network of providers, making it unlikely you would need to change doctors. In addition, UnitedHealthcare doctors have agreed to work with us for meaningful, positive changes in health care – changes that can benefit you and your family.