Results of the Wisconsin Business Group on Health (BHCG) Second Physician Value Study showed the potential for substantial cost savings through improved physician performance. The Study, commissioned by BHCG was conducted by GNS Healthcare (a leading provider of artificial intelligence applications in health care). The study used claims data (2018-2019) available through the Wisconsin Health information Organization (WHIO), which collects claims data from Wisconsin health insurers, self-funded employers that pay their employees’ health-care costs directly, and Medicaid.
Like the first one conducted in 2019, the results of this Study showed the potential for substantial cost savings through improved physician performance. Specifically, the analysis showed if the performance of physicians could be improved to the 50th percentile or above; or if patients could be steered to providers performing at the 50th percentile or above, statewide savings would be nearly:
- $325 million in primary care costs annually; and
- $58 million in specialist costs annually (for just 10 procedures that were analyzed).
In summary, a total of $382 million could be saved annually if primary care physicians and specialists who scored below the 50th percentile changed their patterns of practice to score above the 50th percentile of cost-efficiency scores.
The new BHCG-Centivo high-performance, primary care-centered health plan used the Study results as the foundation to develop the provider networks for the health plan, effective January 1, 2022. The health plan will make only high-performing primary care providers from each contracted health system available for selection by members, ensuring care is directed to high-value providers.
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