Business Health Care Group, Centivo claim 23 to 36 percent reduction in medical costs last year

The Business Health Care Group, a coalition of employers with self-funded health plans, says they were able to reduce medical costs by 23 to 36 percent last year through their partnership with Centivo, a New York-based health plan.

The two organizations have worked together in recent years to develop efforts focused on high-value care and release studies showing that steering patients toward high-performing doctors and helping physicians improve could save hundreds of millions. The studies have drawn concerns from hospitals.

Centivo CEO Ashok Subramanian said their model is centered around primary care. Over the past 12 months, they’ve seen primary care visits rise by 29 percent, and emergency room visits and inpatient admissions fall by 31 percent and 17 percent.

He noted the results are a sole year of data, but they mimic what they’ve seen elsewhere from other efforts to hone in on primary care.

“The reality is it works,” Subramanian said at a Business Health Care Group symposium earlier this month. “It works to bring people back into the system, it works to make sure they’re not medically homeless and it works to have somebody that you trust.”

Speaking at a panel at the event, Drew Hodgson, national practice leader in healthcare delivery at Willis Towers Watson, called the work done by Centivo “remarkable” and said he has “no doubt that it’s driving strong results.”

“I’m a consultant. Every time I see numbers, like 23 to 36 percent, I go, ‘Hmmm, really?’” he said. “That’s just who I am, and I’m always going to be that way. So I’m not saying it’s not true, but I think sometimes employers — and the community out there — (are) going to have a heavy dose of skepticism.”

Business Health Care Group Executive Director Jeff Kluever noted that Centivo can fill the gap caused by WEA Trust ending its health insurance offerings and Humana’s planned departure from employer insurance in the coming months.

“There is an incredible opportunity here to change the dynamic in the state,” he said.

This article first appeared in the Wisconsin Health News daily email newsletter. Sign up for your free trial here.