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[accordion-item title="History/organizational structure"]
The Business Health Care Group grew out of the frustration felt by several CEOs of large Milwaukee-based employers concerning health care costs in southeast Wisconsin as compared to their other 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 our area was going to maintain jobs in our market.
The CEOs 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, walking in unison with a common strategy, to impact the costs of health care in southeast Wisconsin. Ultimately, 11 corporations with headquarters in southeast Wisconsin and two other existing coalitions founded BHCG as a member-owned Limited Liability Corporation (LLC) in 2003 to explore alternatives to contain health care costs in the region. They soon established a goal to get costs at or below the Midwest average within five years.
The first step toward walking in unison was to select an administrator/insurer to allow BHCG to have one voice in the market. In December of 2004 BHCG selected Humana to be the sole administrator/insurer of its members’ affiliated health plans. Humana agreed to allow exclusive access to its high performance network, Humana Preferred, to BHCG. In 2005 Humana re-contracted with providers on behalf of BHCG and made the network and BHCG Preferred health plan available exclusively to BHCG employers on January 1, 2006.
In 2015 BHCG announced that it would be switching administrative partners, replacing Humana with UnitedHealthcare effective January 1, 2016. This decision was made after an extensive strategic planning process identified the future course of the organization. That identified strategic course matched closely the strategic direction that UnitedHealthcare is pursuing and consequently the decision was made to switch administrative partners.
In 2016 our service area expanded in to northeast Wisconsin and now includes a total of 22 counties: 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. Today employer groups of all sizes participate in BHCG, representing approximately 140,000 covered lives.
[accordion-item title="Mission statement"]
The Business Health Care Group leverages member employer purchasing power and knowledge to lead change. We create value through innovative shared strategies to improve health care quality and cost efficiency for employers, employees and the community.
[accordion-item title="Philosophy & strategy"]
Several core principles, established during our formation, continue to serve us well in advancing our mission:
- Accountability from all stakeholders including health care consumers, health care providers, employers and our health plan administrator, UnitedHealthcare.
- Consumers need to be held accountable for becoming more engaged in their own health and to use information to make informed buying decisions.
- Health care providers need to be held accountable for compliance with evidence-based medicine, outcomes and efficiency.
- Employers need to design health plans, offer wellness programs and provide consumer education based on best practices.
- The administrator must meet the needs of the local market, have the ability to support engaged employers, assist in removing barriers to reforming the market, provide transparency of cost and quality information and perform their core activities efficiently and effectively.
- A network strategy which promotes competition.
- We strive to enter into provider contracts with fixed prices as opposed to arrangements with a percentage off charges which provides motivation for providers to become efficient.
- Our member companies support a broad network approach coupled with the identification of a select subset of providers recognized for delivering high quality, efficient care.
- Education of both employers and their employees. Employees must be motivated through plan design and education to become better consumers of health care. Employers must dedicate resources to educate their plan members.
- We develop tools and resources for our employer members to help employees become better educated purchasers of their health care (see Section 3, Member Resources).
- We provide educational forums and support projects that promote best practices for employers to utilize in managing their health care dollars and benefit programs effectively (see Section 3, Member Resources).
[accordion-item title="Strategic partners"]
Wisconsin Collaborative for Healthcare Quality
Who They Are
WCHQ is a voluntary, state-wide provider-driven organization working to improve the quality and cost of health care services delivered to our state’s residents. Formed in 2003, the WCHQ is committed to the development of performance measures for assessing the quality and cost of health care services and to publicly report provider performance data. Visit the WCHQ web site at www.wchq.org to review publicly reported provider performance data.
Synergies with BHCG
Did you know?
BHCG provides the only unified voice to health care purchasers in the market and actively participates in state initiatives that drive quality and efficiency.
WCHQ’s efforts to collect and publicly report standardized provider performance data supports BHCG’s commitment to work with providers to improve health care value and to educate consumers and assist them in making choices using reliable information.
Wisconsin Health Information Organization (WHIO)
Who They Are
WHIO is a voluntary, not for profit public-private partnership with a multi-stakeholder board which includes payers, providers, business and the state government. WHIO has developed a statewide data mart of health care information which can be used to produce comparative analytics on provider performance and evaluate population health. Providers and others use this information to improve value in health care by focusing on quality and efficiency of delivery. For more information about WHIO, please visit their web site at www.wisconsinhealthinfo.org.
Synergies with BHCG
By aggregating data from multiple payers representing a majority of claims in the state, the WHIO data mart creates a robust data set that providers and other interested parties can use to improve care. Providers having access to aggregate data from multiple sources obtain a more complete picture of their practice. Ultimately, WHIO also plans to publicly report its data, thereby adding to health care cost and quality transparency.
WHIO began public reporting of primary care performance (Family Practice, Internal Medicine and Pediatrics) at the clinic site level at MyHealthWI.org
Wisconsin Statewide Health Information Network (WISHIN)
Who They Are
WISHIN, an independent nonprofit organization incorporated in late 2010, is charged with bringing the benefits of widespread, secure and interoperable health information technology to patients and caregivers throughout Wisconsin. As Wisconsin’s State-Designated Entity for Health Information Exchange (HIE), it is responsible for developing HIE capability throughout the state. WISHIN plans to build a statewide health information network to connect physicians, clinics, hospitals, pharmacies, clinical laboratories and others across Wisconsin, regardless of the electronic medical record system they use.
A statewide electronic health information exchange offers the promise of timely, relevant information that can lead to better clinical decisions and outcomes, less duplication, more effective transitions of care and reduced administrative costs. WISHIN’s vision is to improve the health of individuals and communities in Wisconsin by allowing secure electronic sharing of the right information, at the right place and time, with the right individuals. For more information about WISHIN, please visit their web site at: www.wishin.org.
Synergies with BHCG
When patients move from one health care system to another, their health information does not always follow them, potentially leading to duplication of care and poorer clinical outcomes. As more providers join WISHIN and share information, higher quality care with lower costs is a likely outcome.
BHCG maintains organizational memberships and arrangements with key health care and benefits-related groups whose strategies are aligned with our own. Both our organization and our employer members benefit by these alliances:
Midwest Business Group on Health (MBGH)
Made up of large Midwest employers, MBGH serves as one of the nation's leading employer-focused coalitions and is a recognized leader in offering education, research and community-based activities that increase the value of health benefits and health care services. As an employer member of BHCG you are eligible for the following MBGH benefits:
- Participate in all Learning Network educational programs at a special reduced rate of $50.00 (vs. $100) and register for the Annual Conference and Pharmacy Benefits Academy at the Member rate. For the learning programs use code: Coal-MBGHLN
- Participate in MBGH's employer-only networking roundtables on Health Benefits, Wellness, Pharmacy Management and CDHP at no cost (in person or via conference call).
- Participate in MBGH benchmarking surveys on HR/benefits management topics at no cost.
- Gain access to MBGH's Buying Group programs, including pharmacy benefits and other services.
- BHCG members can join MBGH as individual Business Members, at a dues level based on the number of their active employees, with a discount of 50% or $1000, whichever is less. As a member of MBGH they gain access to MBGH staff assistance and advice on their individual benefit programs, access to the Members-Only areas of the MBGH website and free registrations for Learning Network programs.
For more information about MBGH, please visit www.mbgh.org/Home/.
National Alliance of Healthcare Purchaser Coalitions
A national organization of purchaser-led health care coalitions dedicated to value-based purchasing of health care services through the collective action of public and private purchasers. BHCG member employers receive a complimentary registration to the National Alliance's annual conference. For more information, please visit https://nationalalliancehealth.org/
[accordion-item title="Section 1 Links"]