Employer healthcare costs have doubled in the last ten years, far outstripping the inflation rate. For many employers, the provision of healthcare is their single biggest cost. Our projects to reduce health care costs include:
Healthcare Incentives Payment Pilot
CBGH is working with employers in three counties to reduce potentially avoidable medical complications. These complications make up one third of costs of treating certain diseases. Through data analytics, we are sifting through insurance claims to flag avoidable complications. Then, we share data with physicians to improve their performance.
Pharmacy Benefit Management
More than ten years ago when CBGH members expressed an interest in collaborative purchasing, CBGH responded by establishing the Pharmacy Benefit Management (PBM) program. CBGH hired a nationally known consultant to develop a request for proposals (RFP) for third-party administration of pharmacy benefits and coordinated the evaluation and contracting process at no additional cost to the participating members. Four contracting cycles later, CBGH members continue to have an opportunity to leverage CBGH’s collective purchasing power and access to resources to help manage their pharmacy benefits.
CBGH holds the master contract, but each participating member organization retains its autonomy with regard to plan design. Claims risk is not pooled, but members have the opportunity to consider each other’s experience and strategy to inform their own programs.
In addition to economies of scale, the PBM user’s group provides a forum by which participating members benefit from the collective experience and insight of their CBGH colleagues through reporting, discussion and shared benchmarks.