HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, finds that a partnership between the Business Health Care Group of Southeast Wisconsin and Humana Inc. promises to show significant healthcare cost savings. According to the latest issue of Wisconsin Health Plan Analysis from HealthLeaders- InterStudy, the partnership has recently moved into the implementation phase.
The Business Health Care Group formed to battle escalating healthcare costs in the region through consumer-driven efforts, care-management programs, and other avenues. The group partnered with Humana so it could purchase health services collectively, have access to a single claims database, and communicate a consistent message.
"Through its contracting experience, Humana put together a high- performance network, using a methodology to evaluate physicians' efficiency," said Ric Gross, HealthLeaders-InterStudy analyst. "It has contracted with 26 area hospitals and around 4,000 physicians, which is a smaller proportion of the available providers than usual for a health plan. This let them negotiate hard on price."
The new arrangement is expected to increase competition and lower costs. Health plans that compete with Humana, including UnitedHealth and WellPoint, are expected to respond, to prevent the coalition from gaining market momentum that might erode their share. Gross states, "Expect to see more price and performance pressure on providers in Wisconsin."
Other health plan news in Wisconsin: * Wisconsin employers are moving toward high-deductible, consumer-based health plan products, which analysts expect will contribute to a moderation in premium rate increases. * Aurora Health Care, Wisconsin's largest health system, has signed a 15- year contract with UnitedHealthcare, the state's largest health insurer. The deal is expected to be a profitable one for both. * Abri Health Plan, a Medicaid HMO, continues to expand its business in Wisconsin, most recently taking on services to Milwaukee County's SSI population. About HealthLeaders-InterStudy
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