Addendum 1c Top Provider 2020.pdf
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- Attached to
- RFP #2021-03 Health and Wellness Services
- Solicitation number
- 2021 - 03
- Issued by
- Wisconsin
About this file
This is an Addendum document providing health care utilization data for Dunn County, Wisconsin, prepared by Medica Health Plans as supporting information for RFP #2021-03 Health and Wellness Services. The document serves as reference material for qualified service providers responding to Dunn County's request for proposals regarding health insurance and wellness services for county employees and their families. The addendum presents comprehensive claims data and utilization patterns from January 2020 through December 2020, enabling bidders to understand the current healthcare consumption patterns and cost structures within the county's employee population.
The document identifies top healthcare providers by cost, with Mayo Clinic Health System-NW Wisconsin Region dominating at 64.0% of total paid amounts ($1,462,227), followed by MCHS Hospitals Inc. at 7.3% ($165,973) and Mayo Clinic at 6.6% ($151,414). Prescription drug utilization shows Humira as the highest-cost medication at $267,383 (28.2% of total drug costs), followed by Ibrance at $106,554 and Tecfidera at $99,315. Anti-TNF-Alpha Monoclonal Antibodies represent the top drug class by cost at $267,383, with total claims data showing 10,815 events generating $2,284,439 in overall provider costs and 5,978 prescription claims totaling $948,600. This historical utilization data provides bidders with essential baseline information for pricing proposals and developing wellness program strategies targeted at the county's employee health needs.
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Confidential property of Medica Health Plans. Do not reproduce or redistribute without the express written consent of Medica Health Plans.
Top Provider Summary The Top Provider table shows up to the top 25 providers with which your members have accumulated the most cost.
Top Provider Name Events Amount Paid Percent of Total Paid
MAYO CLINIC HEALTH SYSTEM-NW WISCONSIN
REGION INC 7,037 $1,462,227 64.0%
MCHS HOSPITALS INC 254 $165,973 7.3%
MAYO CLINIC 250 $151,414 6.6%
EAU CLAIRE ANESTHESIOLOGISTS LTD 93 $106,173 4.6%
MARSHFIELD CLINIC INC 353 $36,605 1.6%
MAYO HEALTH SYSTEM NORTHWEST
WISCONSIN REGION INC 167 $36,596 1.6%
MAYO CLINIC STORE 230 $33,065 1.4%
CRITICAL CARE SERVICES INC 2 $26,170 1.1%
OAKLEAF CLINICS SC 124 $20,271 0.9%
WESTERN WISCONSIN UROLOGY 17 $19,910 0.9%
CHATTANOOGA HAM CTY HSP AUR/SE 55 $15,008 0.7%
CHIPPEWA VALLEY ORTHO AND SPORTS MED
CLINIC SC 18 $13,612 0.6%
KIVLIN EYE CLINIC 166 $11,092 0.5%
MINIMED DISTRIBUTION CORP 21 $9,196 0.4%
MAYO CLINIC ROCHESTER 45 $8,148 0.4%
MEDICAL X-RAY CONSULTANTS LTD 25 $6,921 0.3%
FOUNDATIONS THERAPY LLC 61 $6,612 0.3%
SACRED HEART HOSPITAL 75 $6,502 0.3%
LAKEVIEW MEDICAL CENTER INC OF RICE LAKE 24 $6,326 0.3%
IHC-SACRED HEART EMERGENCY PHYSICIANS
LLC 10 $6,064 0.3%
SACRED HEART HOSP OF THE HOSP SISTERS - 19 $5,872 0.3%
CITY OF EAU CLAIRE 10 $5,807 0.3%
KCI USA, INC. 2 $5,250 0.2%
GOLD CROSS AMBULANCE SERVICE 6 $4,660 0.2%
PUCKETT EMS INC 10 $4,633 0.2%
Total 9,074 $2,174,106 95.2%
Grand Total 10,815 $2,284,439 100.0 %
10 | DUNN COUNTY | January 2020 - December 2020
Confidential property of Medica Health Plans. Do not reproduce or redistribute without the express written consent of Medica Health Plans.
Top Drugs by Amount Paid The chart displays the top 20 prescription drugs based on amount paid.
Current Prior
Generic Name Drug Class Rank # of Rxs Amount Paid % of Total Paid
Amount Paid/Rx
# of Rxs Amount Paid % of Total Paid
Amount Paid/Rx
Humira Anti-Tnf-Alpha - Monoclonal Antibodies
1 54 $267,383 28.2% $4,951.54 43 $209,234 22.6% $4,865.91
Ibrance 2 9 $106,554 11.2% $11,839.33 0 $0 0.0% $0.00
Tecfidera Multiple Sclerosis Agents 3 13 $99,315 10.5% $7,639.62 11 $78,587 8.5% $7,144.27
Trulicity Incretin Mimetic Agents (Glp-1 Receptor Agonists)
4 71 $56,261 5.9% $792.41 59 $50,374 5.4% $853.80
Novolog Insulin 5 42 $51,975 5.5% $1,237.50 70 $63,610 6.9% $908.71
Biktarvy Antiretrovirals 6 13 $38,586 4.1% $2,968.15 9 $27,274 2.9% $3,030.44
Adderall Amphetamines 7 89 $21,535 2.3% $241.97 0 $0 0.0% $0.00
Tresiba Insulin 8 29 $20,810 2.2% $717.59 45 $34,490 3.7% $766.44
Farxiga Sodium-Glucose Co- Transporter 2 (Sglt2) Inhibitors
9 14 $18,338 1.9% $1,309.86 25 $22,514 2.4% $900.56
Toujeo Max Insulin 10 13 $14,194 1.5% $1,091.85 0 $0 0.0% $0.00
Myfortic Immunosuppressive Agents 11 4 $13,996 1.5% $3,499.00 4 $12,315 1.3% $3,078.75
Eliquis Direct Factor Xa Inhibitors 12 13 $11,444 1.2% $880.38 21 $16,142 1.7% $768.67
Ozempic Incretin Mimetic Agents (Glp-1 Receptor Agonists) 13 8 $10,827 1.1% $1,353.38 10 $8,301 0.9% $830.10
Emgality Migraine Products - Monoclonal Antibodies 14 18 $9,460 1.0% $525.56 9 $5,113 0.6% $568.11
Dexcom G6 Sensor Diabetic Supplies 15 19 $9,445 1.0% $497.11 18 $10,261 1.1% $570.06
Advair Sympathomimetics 16 13 $8,804 0.9% $677.23 33 $14,932 1.6% $452.48
Victoza Incretin Mimetic Agents (Glp-1 Receptor Agonists)
17 4 $8,395 0.9% $2,098.75 3 $7,865 0.8% $2,621.67
Breo Ellipta Sympathomimetics 18 23 $8,160 0.9% $354.78 14 $2,778 0.3% $198.43
Saxenda Anti-Obesity Agents 19 6 $7,692 0.8% $1,282.00 2 $2,463 0.3% $1,231.50
Accu-Chek Aviva Plus Diagnostic Tests 20 22 $7,194 0.8% $327.00 23 $6,124 0.7% $266.26
Total 477 $790,371 83.3% $1,656.96 399 $572,376 61.7% $1,434.53
Grand Total 5,978 $948,600 100.0% $158.68 6,881 $927,818 100.0% $134.84
11 | DUNN COUNTY | January 2020 - December 2020
Confidential property of Medica Health Plans. Do not reproduce or redistribute without the express written consent of Medica Health Plans.
Top Drug Classes by Amount Paid The chart displays up to the top 20 prescription drug classes based on amount paid.
Current Prior Drug Class Rank # of Rxs Amount Paid % of Total
Paid Amount Paid/Rx
# of Rxs Amount Paid % of Total Paid
Amount Paid/Rx
Anti-Tnf-Alpha - Monoclonal Antibodies
1 54 $267,383 28.2% $4,951.54 43 $209,234 22.6% $4,865.91
2 148 $118,194 12.5% $798.61 0 $0 0.0% $0.00
Multiple Sclerosis Agents 3 13 $99,315 10.5% $7,639.62 11 $78,587 8.5% $7,144.27
Insulin 4 106 $93,520 9.9% $882.26 144 $106,833 11.5% $741.90
Incretin Mimetic Agents (Glp-1 Receptor Agonists) 5 83 $75,483 8.0% $909.43 72 $66,539 7.2% $924.15
Antiretrovirals 6 15 $39,484 4.2% $2,632.27 13 $40,108 4.3% $3,085.23
Amphetamines 7 123 $23,653 2.5% $192.30 127 $8,029 0.9% $63.22
Sympathomimetics 8 155 $22,124 2.3% $142.74 210 $37,183 4.0% $177.06
Immunosuppressive Agents 9 16 $18,408 1.9% $1,150.50 24 $20,664 2.2% $861.00
Sodium-Glucose Co-Transporter 2 (Sglt2) Inhibitors 10 14 $18,338 1.9% $1,309.86 25 $22,514 2.4% $900.56
Diabetic Supplies 11 90 $16,643 1.8% $184.92 116 $17,384 1.9% $149.86
Direct Factor Xa Inhibitors 12 19 $13,824 1.5% $727.58 26 $18,006 1.9% $692.58
Anticonvulsants - Misc. 13 128 $9,583 1.0% $74.87 152 $42,596 4.6% $280.24
Migraine Products - Monoclonal Antibodies 14 18 $9,460 1.0% $525.56 10 $5,681 0.6% $568.10
Diagnostic Tests 15 46 $8,976 0.9% $195.13 86 $12,838 1.4% $149.28
Combination Contraceptives - Oral
16 184 $7,956 0.8% $43.24 211 $7,705 0.8% $36.52
Anti-Obesity Agents 17 6 $7,692 0.8% $1,282.00 2 $2,463 0.3% $1,231.50
Viral Vaccines 18 45 $6,889 0.7% $153.09 76 $5,377 0.6% $70.75
Smoking Deterrents 19 19 $6,319 0.7% $332.58 19 $6,496 0.7% $341.89
Hmg Coa Reductase Inhibitors 20 267 $6,186 0.7% $23.17 294 $10,334 1.1% $35.15
Total 1,549 $869,431 91.7% $561.29 1,661 $718,573 77.4% $432.61
Grand Total 5,978 $948,600 100.0% $158.68 6,881 $927,818 100.0% $134.84
12 | DUNN COUNTY | January 2020 - December 2020
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