Business Health Care

Name

Business Health Care

Legal name

Business Health Care Group of Wisconsin, LLC

Website

https://bhcgwi.org

Company type

Private

Founded year

2003

Operating status

Operating

Headcount range

1–10 employees

Ownership category

akta.pro rank

Product category

Employer Health Care Coalition

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292), Health and Welfare Funds (52512)

SIC

Insurance Agents, Brokers & Service (6411), Hospital & Medical Service Plans (6324)

akta.pro industry

PRIMARYFSAIAFAE

Large Group Health Insurance (Mid-Market & National Accounts)

Financial & Insurance/Insurance — Life & Health/Group Health Insurance (Employer-Sponsored)

SECONDARYHLAEALAK

Flexible Benefits Administration (FSA/HSA/HRA)

Healthcare & Life Sciences/Health Insurance & Managed Care/Third-Party Administration (TPA) & Administrative Services Only (ASO)

SECONDARYHLAEAKAE

Specialty Pharmacy Benefit Management (Specialty PBM)

Healthcare & Life Sciences/Health Insurance & Managed Care/Pharmacy Benefit Management (PBM)

Keywords

• Employer health coalition
• Group health benefits
• High-performance health plan
• Pharmacy benefit management
• Benefits analytics platform

Headquarters

HQ city

Waukesha

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Marketing or Sales, Operations, Technology or R&D

Revenue model

1. Employer Membership Dues: Membership fees from employers of all sizes throughout Wisconsin and nationwide who join BHCG to access programs, services, preferred pricing, performance guarantees, and exclusive capabilities from strategic partners.
2. Affiliate Membership Dues: Annual fee of $3,500 for health-aligned organizations seeking to expand visibility, strengthen employer relationships, and engage with the coalition. Benefits include website visibility, newsletter recognition, event participation, and preferred sponsorship opportunities.
3. Event Sponsorships: Sponsorship revenue from Connect360 Learning Series, Annual Meetings, and Golf Outings. Connect360 events: $500/individual or $4,000/full series. Annual Meeting: Platinum $10,000, Gold $4,000, Vendor $2,000. Golf Outing: Platinum $12,500, Gold $10,000, Silver $7,500, and various hole/contest sponsorships.

Pricing tiers

Go-to-market motion1 record

Distribution channels3 records

Marketing channels9 records

Core offering

BHCG operates as a member-owned employer coalition that unites Wisconsin employers to leverage collective purchasing power for high-quality, cost-effective health care. The core offering is the BHCG-Centivo High-Performance Health Plan, a primary care-centered plan that identifies high-value providers and rewards value over volume. Supporting the core plan are Physician Value Studies (AI-driven analytics on Wisconsin physicians), Advanced Benefits Analytics, Rightway pharmacy benefits, HPS/PayMedix payments, and employee benefits communications, plus affiliate offerings like Twin Health and Holista Episodes of Care.

Product overview

Business Health Care Group operates as a coalition platform offering multiple interconnected health care solutions for Wisconsin employers. The core offering is the BHCG-Centivo High-Performance Health Plan, a primary care-centered model that identifies high-value providers and rewards value over volume. Supporting this core product are the Physician Value Studies (AI-powered analytics by AITIA), Advanced Benefits Analytics (Artemis By Nomi Health), Rightway Pharmacy Benefits, HPS/PayMedix healthcare payments, and the Opioid Communications Toolkit. Affiliate offerings include Twin Health's AI digital twin technology and Holista's bundled Episodes of Care. The portfolio is unified by a data-driven approach to improving health care quality and cost efficiency through employer collaboration.

Differentiator

Problem solved

Functional benefit

Products and services

• BHCG-Centivo High-Performance Health Plan A primary care-centered health plan solution developed in partnership with Centivo that identifies high-value providers and rewards them for value over volume. The plan directs patients to high-value providers, encourages coordinated care through primary care physicians, and offers broad, intermediate, and value provider networks (WI-1, WI-2, WI-3) for BHCG member employers.
• Physician Value Studies Commissioned studies conducted by AITIA that analyze data from the Wisconsin Health Information Organization (WHIO) All-Payer Claims Database to evaluate physician quality and cost-effectiveness across Wisconsin, identifying opportunities for cost savings and supporting value-based care decisions for BHCG member employers.
• Advanced Benefits Analytics Artemis By Nomi Health's advanced analytics platform that connects all employer data sources, adds visualization tools, and aggregates data from non-traditional sources including 401k programs, wellness initiatives, care management programs, and point solutions to evaluate benefits ROI for BHCG member employers.
• Rightway Pharmacy Benefits A member-first pharmacy benefits management solution combining clinical pharmacist support with advanced technology to guide members to high-value medications while delivering transparent pricing and total spend guarantees to BHCG member employers.
• HPS/PayMedix Healthcare Payments Wisconsin-based healthcare payments and network solution that pays providers in full, consolidates medical claims into a single statement, and offers members flexible interest-free options to manage out-of-pocket costs, available to BHCG member employers.
• Twin Health Metabolic Health Solution AI digital twin technology that creates a real-time model of each individual's unique metabolism using data from smart devices, lab results, and meal logs to provide personalized guidance on nutrition, activity, sleep, and more, delivered as an affiliate offering to BHCG member employers.
• Holista Episodes of Care Bundled healthcare packages with transparent fixed pricing that eliminate surprise bills for specialty procedures like orthopedic surgery, imaging, and maternity care, with dedicated Care Coordinators and warranty protection, available as an affiliate offering to BHCG member employers.
• Employee Benefits Communications Communications services provided by The Write Source and AFFIRM offering open enrollment materials, benefits guides, awareness campaigns, multi-media communications, newsletters, and social media strategies at preferred rates for BHCG member employers from mid-sized to Fortune 100.

Quantifiable outcome

• 16% lower health care costs vs industry benchmark ($55 vs $59 PMPM)
• +8 more outcomes

Named customers15 records

Segments4 records

Ideal customer profiles3 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability4 records

Feature3 records

Partnerships

19 partnerships are on record, tiered flagship, core and minor.

• CentivoflagshipStrategic or Co-development PartnerCentivo is BHCG's primary health plan administrator for the high-performance, primary care-centered health plan solution effective January 1, 2022. The partnership delivers up to 20% lower total cost of care through direct partnership with high-performing health systems and providers. BHCG-Centivo plan members achieved 16% lower medical costs vs industry benchmark in 2025. Centivo also serves as Platinum sponsor for BHCG events.
• AitiacoreTechnology or IntegrationAitia (formerly GNS Healthcare) provides artificial intelligence and advanced data analytics for BHCG's Physician Value Studies. BHCG commissioned PVS 1.0 (2019), PVS 2.0 (2021), and PVS 3.0 (2025) using WHIO data to evaluate physician quality and cost-effectiveness throughout Wisconsin. Results identify $394M in potential savings (31.1% cost savings).
• Artemis By Nomi HealthcoreStrategic or Co-development PartnerArtemis By Nomi Health provides advanced benefits analytics platform for BHCG member employers. The platform connects all employer data sources, adds visualization tools, and enables evaluation of all benefits offerings and ROI. Partnership enhances BHCG membership value by providing powerful data analytics tools.
• RightwaycoreStrategic or Co-development PartnerRightway is BHCG's pharmacy benefit management partner selected through comprehensive RFP process. Delivers 13% gross pharmacy savings opportunity and combines clinical pharmacist support with advanced technology. Rightway is Platinum sponsor for BHCG Golf Outing and provides PBM solutions to member employers.
• HPS/PayMedixcoreStrategic or Co-development PartnerHPS (Health Payment Systems) and PayMedix provide Wisconsin-based healthcare payments and network solutions. HPS offers high-performing local provider networks with competitive discounts and flexible plan design. PayMedix pays providers in full and offers members flexible, interest-free options for out-of-pocket costs. Sponsor of BHCG events including Golf Outing.
• Wisconsin Health Information Organization (WHIO)coreStrategic or Co-development PartnerWHIO maintains Wisconsin's All-Payer Claims Database (APCD), the state's most comprehensive source of health care data representing the majority of covered lives. WHIO data powers BHCG's Physician Value Studies and enables evaluation of physician quality and cost-efficiency statewide.
• Wisconsin Collaborative for Healthcare Quality (WCHQ)minorStrategic or Co-development PartnerWCHQ is encouraged by BHCG for health systems and provider groups to become members, share best practices, and publicly report quality performance for consumers.
• National Alliance of Healthcare Purchaser CoalitionsminorStrategic or Co-development PartnerNational organization of purchaser-led health care coalitions dedicated to value-based purchasing of health care services through collective action. BHCG maintains membership for access to best practices and national coordination.
• Wellness Council of WisconsinminorStrategic or Co-development PartnerOrganization dedicated to helping employers design results-oriented wellness programs to maximize employee health and productivity. BHCG member employers benefit through access to educational programs and resources.
• Reinhart Boerner Van Deuren s.c.minorStrategic or Co-development PartnerReinhart is a national corporate law firm headquartered in Milwaukee with 200+ attorneys. Provides employee benefits legal services to BHCG and member employers. Contact: John Barlament, Shareholder.
• Twin HealthminorStrategic or Co-development PartnerTwin Health provides AI digital twin technology creating real-time metabolic models for personalized health guidance. Delivers $8.0K+ annualized savings per member by reducing reliance on high-cost medications. Affiliate member providing metabolic health solutions.
• Ethica Pharmacy AdvisorsminorStrategic or Co-development PartnerIndependent pharmacy consulting firm providing transparency in PBM contracts, cost analysis, and negotiation support. Helps clients navigate pharmaceutical landscape with financial control and quality care. Contact: Connie Perry.
• HolistaminorStrategic or Co-development PartnerHolista provides Episodes of Care with transparent, fixed pricing for specialty procedures (orthopedic surgery, imaging, maternity). Care Coordinators guide employees through procedures with $3,000-$10,000+ savings per procedure. Sponsor of BHCG events.
• QuadMedminorStrategic or Co-development PartnerQuadMed partners with employers to provide whole-person care including primary care, occupational health, behavioral health, physical therapy, and wellness coaching. 30+ years of employer healthcare experience. Contact: Lisa Ness, Chief Growth Officer.
• Solstice HealthminorStrategic or Co-development PartnerWisconsin-based organization combining Direct Primary Care, Direct Surgical Care, medical-grade Hyperbaric Oxygen Therapy, and wellness services. Provides transparent, affordable care with predictable pricing since 2012. Contact: Timothy Murray, Founder & CEO.
• Astia HealthminorStrategic or Co-development PartnerAdvanced Direct Primary Care provider built for self-funded employers. Integrates advanced care delivery with cost containment and workforce wellbeing. Features Plan Aligned Care Delivery and Real-Time Data Intelligence. Contact: Dr. Alex Sommers, President.
• Compass Health CenterminorStrategic or Co-development PartnerProvides immediate behavioral health care through Partial Hospitalization (PHP) and Intensive Outpatient (IOP) Programs. Offers virtual and in-person treatment options for Wisconsin residents. Contact: Justine Mitchell, SVP.
• The Write Source / AFFIRMcoreImplementation/ SI/ Consulting PartnerBHCG's preferred communications partners since 2008 providing employee benefits communications services to employers from mid-sized to Fortune 100. Preferred rate for member employers (10-20% discount). Services include open enrollment materials, benefits guides, awareness campaigns, and newsletters.
• Milwaukee Business JournalminorGTM or Marketing PartnerMilwaukee Business Journal partners with BHCG and Centivo for Power Breakfast Series sponsorship. Business information and networking series featuring CEOs and business headline makers in Q&A format held at Pfister Hotel.

Scale indicators13 records

Recent moves4 records

Expansion highlights4 records

Others

• Leapfrog Group: National employer-driven watchdog organization focused on health care safety, quality, and transparency. Adjacent to BHCG in serving large employer purchasers and producing public quality data, but operates as a national rating/advocacy entity rather than a regional purchasing coalition.

Direct peers

• Northeast Business Group on Health: New York-based employer coalition aggregating large Northeast employers to drive value-based care, advanced primary care, and pharmacy benefit transparency. Closely mirrors BHCG's mission and operating model at larger regional scale.
• Purchaser Business Group on Health (formerly Pacific Business Group on Health): National employer purchasing coalition that pools collective buying power across large self-funded employers to drive value-based health care. PBGH is the most direct analogue to BHCG at national scale, using shared data and analytics to negotiate with providers and payers on behalf of member employers.
• St. Louis Area Business Health Coalition: Regional employer coalition serving St. Louis-area employers with collective health benefit purchasing, data analytics, and quality improvement initiatives. Operationally comparable to BHCG in size and member-driven governance model.
• Houston Business Coalition on Health: Regional Texas employer coalition using collective action to improve health care quality and cost. Same employer coalition archetype as BHCG, with member employers accessing shared analytics, network strategies, and educational programming.
• Memphis Business Group on Health: Mid-South employer coalition focused on value-based purchasing and transparent health care for member employers. Operates a near-identical coalition model to BHCG with overlapping employer pain points around cost containment and provider performance transparency.
• National Alliance of Healthcare Purchaser Coalitions: National umbrella organization of regional employer purchaser coalitions that BHCG already partners with. The National Alliance coordinates best-practice sharing across regional coalitions like BHCG and operates analogous collective-action employer health benefit models across multiple states.
• Midwest Business Group on Health: Chicago-based employer coalition serving large Midwest self-funded employers with health benefit analytics, PBM oversight, and collective purchasing programs. Operates the same employer-led collective-action model as BHCG and represents the most direct regional peer.

Emerging players

• Rightway Healthcare: Transparent PBM and care navigation partner selected by BHCG through RFP. Operates as a niche PBM that competing employer coalitions and direct employers (including BHCG's members) also access, representing a parallel emerging player in the coalition-PBM value chain.
• Centivo: Health plan administrator and BHCG's flagship partner for the high-performance primary-care-centered plan. While not a coalition itself, Centivo is the underlying operating layer BHCG wraps its coalition model around, and other employer coalitions use comparable arrangements.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks1 record

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/business-health-care-group
• Xx.com/bhcgsw

Revenue estimate

Valuation estimate

Number of profiles

Profiles2 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Business Health Care