Case Studies May 29, 2026 By PHA

The City and County of Denver Modernizes its Plan Design

Company Profile:

~14,000 employees
Self-funded public employer

The Challenge:

The city sought to modernize its healthcare benefits, which had been essentially unchanged for a decade, and guide its workforce to higher-quality care. The organization also sought to leverage its name recognition as a major local employer — all the while working to gain access to its own claims data — which its TPA unsuccessfully sought to block.

The Data-Access Fight:

Given that it is a public employer subject to open records requests, the city found its TPA’s actions “shocking.” Following a 10-month battle, PBGH’s Advisory Services team successfully helped the City and County of Denver secure their data from the carrier.

What the City and County of Denver Found:

High Cost ≠ High Quality: Its workers’ most used hospital had negotiated the highest prices — but had some of the lowest safety grades.
Wide variations in gastroenterology quality, surprisingly high ER prices, and below-average primary care quality at a facility that employees had once been encouraged to use.

How the City and County of Denver Leveraged the Findings:

A reimagined plan design. “We have traditionally encouraged our employees to enroll in high-deductible health plans, and what we’ve realized is that it’s probably not a great strategy,” said a benefits leader. “It was the thing to do a decade ago, but it is time for us to modernize our healthcare.”
New possibilities for network redesign. The organization considered different network configurations and incentives to steer employees toward hospitals with better outcomes.
Improved employee guidance. The organization relied on quality and cost data to direct workers to care that promotes better health.
New direct-contracting possibilities, leveraging the organization’s vast name recognition to secure preferred pricing arrangements.

Bottom Line

“It provides us the leverage we need to modernize our health plan offerings to our employees,” said one benefits leader. “From a wellness and well-being perspective, we can really highlight quality and cost data for our employees so that we can help guide them to better care.”