The Catalyst

The Catalyst

Did You Know…? July 2019

BHCG’s Delivering Value Series Ascension Wisconsin Symposium Draws Media Attention

BHCG’s second symposium of our Delivering Value Series, held on May 30, was featured in The Milwaukee Business Journal. The event highlighted how BHCG strategic partners, member employers and health systems will collaborate and use analytics to increase health care value for plan members, employers and the community.

Navitus Health Solutions Works with California’s Self-Funded School Districts

Navitus Health Solutions, BHCG’s strategic partner and preferred pharmacy benefit manager, was featured in a May 2019 article produced by the Catalyst for Payment Reform.  The case study, “Attacking Waste through Formulary Management,” examined results of the partnership between Navitus and Self-Insured Schools of California (SISC). SISC, which has over 250,000 members covered under a carve-out PBM solution with Navitus, overhauled their benefit design relying on three principles that are key to the Navitus solution: attacking waste, ensuring lowest net cost and transparent pricing.

SISC achieved significant cost trend and PMPM savings with Navitus. Their pharmacy benefit rate increases totaled 10.6% in the past five years, compared to a nationwide trend that totaled 39.9%. For three of the past five years, SISC’s year-over-year pharmacy benefit rate renewals have been flat.

The case study shines a spotlight on the value of the BHCG-Navitus partnership as member employers and prospects begin to evaluate their PBM options for 2020.

Helping Kids. Changing Lives: UnitedHealthcare Children’s Foundation Seeks Funding and Applicants for Medical Grants

UnitedHealthcare Children’s Foundation’s (UHCCF) stated mission is to, “improve children’s lives and help families gain access to the care they need through medical grants.” UHCCF, founded in 1999, provides medical grants to help children gain access to health-related services not covered, or not fully covered, by their family’s commercial health insurance plan. They do not need to have insurance through UnitedHealthcare to be eligible.

UHCCF’s goal is to award 20,000 medical grants to children and their families by 2020. In 2018, UHCCF awarded 2,509 medical grants worth an estimated $3.9 million and is poised to award 3,300 awards in 2019.

For more information about getting involved in fundraising activities or learning how an employee can apply for a grant, please visit the UHCCF website.

UMR Premium Designation and Tier 1 Communication Materials & Videos Now Available

BHCG’s strategic partner, Engagement Solutions, has developed an online library of multi-channel media communications materials, including consumer videos. The materials are provided to support employers’ internal communication efforts when converting to a UMR Premium designation tiered provider plan (a requirement of the pilot). They are designed to help employers increase utilization of Premium®Care physicians among their plan members by educating them on the benefits of effectively using Tier 1 providers within their medical plan benefit.

In February, 2018 BHCG and UnitedHealthcare announced a two-year Premium designation/Tier 1 program pilot available for UMR clients. This opportunity, providing employers' credits to completely offset BHCG’s annual membership fee, is still available to eligible UMR clients.

For more information about this pilot project or Engagement Solutions’ communication materials, please contact Jeffrey Kluever, executive director of BHCG at 262-875-3312 X1 or

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.