April 2018

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Growth and Enhancing the Value of Membership

From the Executive Director

Jeffrey Kluever

Building on the substantial membership gains in the past year, I am pleased to announce another major employer will be joining BHCG's ranks very soon. Effective May 1, we will welcome Sendik's Food Markets. We anticipate several more eastern Wisconsin employers joining our ranks during the remainder of 2018 and for January 1, 2019.

In addition to growth, our other focus in 2018 is continuing to enhance the value of membership in our organization. In the last edition of The Catalyst I reported on some of our priorities for 2018. I would like to update you on one of those priorities — the development of a new contract with a pharmacy benefit manager (PBM).

Our goal is to create a new and transformative pharmacy management partnership for our member employers. A key step in achieving this goal was the selection of Chris Robbins, CEO of Arxcel Consulting to help us select and negotiate with a PBM. At a recent Benefits Forum meeting with member employers Chris outlined some guiding principles for the negotiation. These include:

  • Cost — not price — matters (higher-priced drugs yield higher rebates, but not lower costs)
  • Real savings on pharmacy costs come from appropriate clinical management, not discounts and rebates
  • Employers need to pay for value — embracing value-based drug benefit design:
    • Spending more on higher value drugs is a good investment and in certain clinical scenarios can lower total costs
    • Spending on low value care — not just drugs — should be reduced to free up dollars for higher value care
    • Base the employee cost share on the value of a drug not the cost of a drug

We are enthused about this initiative and its contribution to the value proposition of BHCG membership. Watch for further updates as this project progresses.

As always, do not hesitate to contact me at 262-875-3312 x1 or jkluever@BHCGWI.org if you have questions or would like to learn more about BHCG.

Return to The Catalyst

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. BHCG membership exceeds 200,000 covered lives in the 22-county region of eastern Wisconsin.