BHCG, in conjunction with Centivo, has developed two new products exclusively for member employers that complement the high-performance health plan solution.
Specialist Identification for Onsite/Near-Site Clinics
Utilizing Centivo’s referral portal, health care providers staffing member employers’ onsite or near-site clinics will be able to identify high value specialists throughout the state of Wisconsin – measured on both quality and cost efficiency metrics – to refer patients in need of additional services. High value specialists were identified using the results of the second BHCG-sponsored Physician Value Study conducted by GNS Healthcare. The Study also revealed substantial savings opportunities if patients had seen high-value specialists.
Level-Funded Product
Beginning later in 2022, BHCG and Centivo will offer a level-funded product in Wisconsin. A level-funded product, tailored for employers with as few as 51 employees, is a type of health insurance that mimics a fully-insured plan while providing the key advantages that benefit larger self-funded employers. With a level-funded product, an employer pays a fixed monthly amount, typically set at a target of 110-120 percent of expected claims and expenses. An employer’s costs cannot exceed the monthly amount; instead, Centivo and its reinsurance partners are at risk for meeting expected cost targets. If an employer’s cost experience is better than the target amount, the employer receives a refund of the difference between their contribution and their actual cost experience. This approach allows employers to benefit from good medical cost performance while not risking higher, unforeseen costs above budgeted levels – a “win/no lose” proposition.
For more information concerning either of these products, please contact BHCG Executive Director Jeffrey Kluever, at 262-875-3312 X1 or jkluever@bhcgwi.org.