High-Performance Health Plan Solution Plans Set for Market Launch

Jeffrey Kluever

Jeffrey Kluever

In my January column of The Catalyst, I provided an overview of several initiatives we will be working on throughout 2021, including introducing you to our partnership with Centivo to develop Wisconsin’s first high-performance health plan solution – exclusively for BHCG member employers – featuring a primary care-centered model. In this edition I want to update you on the substantial progress we have made in bringing this initiative to fruition.

Addressing a significant problem

This is a business community and BHCG initiative for eastern Wisconsin and is an effort to address a key issue in doing business in eastern Wisconsin, namely, health care in Wisconsin remains unaffordable for employers, employees and their families. The status quo is simply unsustainable.

We need to take costs out of the system. The way to do this long-term is to work directly with health systems and provider groups to create a plan that achieves our objectives and rewards them for value and not volume. We also know that strong relationships with primary care providers help plan members navigate the system and support them in making better health care choices to get the right treatment at the right time. We have an issue of medical homelessness among too many of our employees and their families who have no connections to a primary care physician. This new high-performance, primary care-driven model directly addresses this issue.

Network development

To date, Centivo has made great progress in the development of the provider networks which will support the high-performance plan solution. Earlier this month we announced the first health systems and provider groups which have agreed to join our three different network configurations – a narrow, an intermediate and a broad network – in eastern Wisconsin, effective January 1, 2022. Please note, additional health systems will be added in the coming months to each of these network configurations.

  • Narrow Network (WI-3): Ascension Wisconsin, ProHealth Care and Independent Physicians Network
  • Intermediate Network (WI-2): Ascension Wisconsin, ProHealth Care, Independent Physicians Network and Froedtert
  • Broad Network (WI-1): Ascension Wisconsin, ProHealth Care, Independent Physicians Network, Froedtert and Advocate Aurora Health

Significant savings potential

Centivo is projecting employers can reduce their adult medical health care spend substantially, depending on which network configuration they choose. On average, employers adopting a:

  • Narrow network could anticipate saving 20-35 percent
  • Hybrid network could anticipate saving 12-19 percent
  • Broad network could anticipate saving 7-9 percent

Flexible network options

Centivo has recently joined forces with Health Payment Systems (HPS) as a network option for the BHCG-Centivo high performance health plan offering. BHCG self-funded member employers with employees in eastern Wisconsin can offer their employees the option of HPS’s traditional broad-based network, administered by Centivo, alongside Centivo’s high-performance primary care-centered health plan. If member employers have employees located outside eastern Wisconsin, they can also access Cigna’s national network.

For employers interested in keeping their existing carrier, the Centivo networks can be offered alongside your current health plan options.

Momentum building

We are truly enthused about the significant interest we have received from member employers, prospects and their advisors about Wisconsin’s first high-performance health plan solution. A number of employers, both BHCG members and prospective members, plan to move to a Centivo network solution as either a full replacement for their existing medical plan offering, or as an option alongside another network option.

News media coverage of our initiative has added to the momentum we are seeing in the community. In the past couple of weeks both Milwaukee Business Journal and BizTimes Media published articles about our recent product launch event and the progress we are making to address the unaffordability of health care in Wisconsin.

Want to learn more?

We encourage all health care stakeholders – employers, their advisors and providers – to view the video recordings from our product launch meeting held on June 16 to learn more about our partnership with Centivo, the status of network development and how employers and providers are embracing this high-performance health plan solution.

Video 1: BHCG Centivo Event Opening Remarks

Video 2: BHCG/Centivo Event: Ashok Subramainian, CEO and Founder, Centivo

Video 3: BHCG/Centivo Event: Provider Panel Discussion

Video 4: BHCG Centivo Event: Employer Panel Discussion

If you would like more information about the BHCG-Centivo partnership and the network offerings or have questions, please feel free to contact me at jkluever@bhcgwi.org or 262-875-3312 X1.