BAC Health Care Purchasing Coalition
Notice to the Local Fund Administrator
Re: BAC Health Care Coalition – Analysis Performed and Data Needed
Below are the types of analyses that United Healthcare (UHC) can perform for Local Trust Funds (LTFs) that are considering joining the Bricklayers and Allied Craftworkers (BAC) Health Care Purchasing Coalition (HCPC). Also listed below is the data needed to complete each of the analyses.
-
: Participants’ zip codes are matched against UHC’s Choice Plus in-network providers’ locations to analyze proximity to in-network Physicians, Specialists and Hospitals. Access and Proximity to Premium in-network providers is also given. The results specify the portion of the participants that have two in-network Primary Care Physicians within 10 miles, two Specialist Care Physicians within 10 miles, and at least one in-network Hospital within 15 miles. The results are also provided for access to physicians and hospitals within 30 miles since the BAC HCPC standard plan designs provide in-network benefits for out-of-network providers to members who do not have provider access to in-network providers within 30 miles of their home.
Data Needed: A current eligibility or census electronic file that contains the members’ and their dependents’ home zip code.
-
: Current Providers are matched against UHC’s network of providers to determine how many are in-network. This enables the LTF to determine the impact of the change of networks on the participants. Consideration should be given to the fact that UHC may have providers that members prefer to use that are not in their current network. This analysis would not reveal that information.
Data Needed: A list of provider names, TINs, physical address including zip code and street address, and type of provider (the last item is preferred but not needed).
-
: Claims information provided by the LTF is analyzed by UHC to determine the average discount that would have been provided if the exact same providers were utilized as listed in the data provided.
Data needed: Click on the Excel file for the "Repricing" data layout:
Repricing Information
-
: This compares the current network and medical management to UHC’s Choice Plus network. It also provides a network discount guarantee. A number below 1.0 means that there is a savings. For example, a 0.90 NEF would translate to a 10% savings on claims costs. For example, the average discount might be guaranteed as 55% instead of 50%.
Data Needed: Name of the current network and medical manager along with the data requested in item #1.
-
: Other analyses can be performed. Some examples include 1) Marketplace reports that compare the number of healthcare providers in your current network vs. UHC’s Choice Plus network by county and provider type (e.g., doctors and hospitals). Current members’ zip codes are needed for this analysis. 2) Disease prevalence analysis could be used to help LTFs decide if they would like to engage UHC in the more in-depth disease management services. Individual claims with ICD-9 codes or prescription drug claims would be needed for this analysis.
Please note that it takes 60 days to implement a BAC HCPC standard plan (similar to your current benefits) and 90 days to implement a BAC HCPC custom plan (your current exact benefits).
Your request and information should be sent directly to:
Anne Codd
Executive Director
BAC Health Care Purchasing Coalition
Phone: 202-383-3976
acodd@bacweb.org
