Organizations continue to show dramatic differences in their ability to manage their health care cost trends. A group of organizations that we refer to as “consistent performers” has been successful in maintaining health care cost trends at or below the TW/NBGH norm for each of the last four years. Our research this year identii ed 43 companies that qualify as consistent performers. 4 Figure 8 shows that the ability to keep cost increases low over an extended period of time distinguishes these companies from other organizations. In fact, the median trend across the last four years was , versus for.