Reference-based pricing also debunks several widely held assumptions about the cost of care. "A lot of times, you hear that higher-cost hospitals are related to quality," Hayes said.

Through reference-based pricing, one tool in the cost containment kit employers should consider, h ealth care consumers learn at least a ballpark of their expected costs upfront in addition to ...

Reference-based pricing can also open more care options and flexibility for employees, leading to lower costs for employees and employers. However, in some cases, employees may be charged the ...

Reference-based pricing is a health care cost containment model that limits what a payor will pay a provider for health care goods and services. Most insurers these days use RBP for certain out-of ...

But reference-based pricing models aren’t without challenges. To function properly, this approach requires a substantial amount of ongoing employee education and personal support. It’s up to the ...

Reference-based pricing (RBP) arrangements take the insurance carrier out of the equation. Kameleon007. By Mary Campbell – Vice President, Account Executive; Parker, Smith & Feek, The Business ...

Most reference-based plans are not state-regulated insurance. Despite a vacuum in state law to address reference-based plans, the Affordable Care Act does create some regulatory overlay, ...

Reference-based pricing (RBP) is an attractive solution because it often carries lower deductibles and contributions for members. Plans allow employers, supported by a third-party administrator, to ...

The Medicare rate is $500, and the reference-based pricing plan’s fixed limit is 200 percent of the Medicare price, which comes out to $1,000. With RBP, the hospital may perform the service and ...

Reference-based pricing plans, in comparison, often reimburse at a lower rate. As a result, hospitals may be seeing a threat to their bottom lines.

Taken together, the two pieces of legislation represent a major effort by lawmakers and officials to curb health care costs.

Reference-based pricing can offer substantial cost savings for employers, but brokers must make them aware of the potential risks.