Is reference-based pricing the future of the health care industry? There are too many fluctuating variables currently in play to say for sure, but one thing is certain: it has a lot of appeal. “To me, being a financial guy, it made sense,” says Mark Gitter, chief financial officer for San Antonio-based GVTC Communications, which hopped on the RBP bandwagon in 2015. “I just want to pay fair market value for the services I get.”
More companies are taking note of the RBP model, which has been around for years, but only recently has seen increased viability and appeal. “It wasn't until organizations decided they were going to absorb financial and legal responsibility for this balance-billing piece that it made it a real option,” says John Simmons, founder and president of StrataBen, and a benefits consultant that helped connect GVTC with Advanced Medical Pricing Solutions (AMPS), one of the first of a growing number of RBP service providers. “Those intersected at the perfect time.”
It's too soon to say whether RBP is the future, but it's not too soon to discuss whether it's the right move for your client.
1. Start the conversation
No matter what your clients' health costs look like or whether you think RBP is a good decision, this first step is a must for anyone. “You should still have the conversation with them that this thing is out there,” says AMPS founder and president Mike Dendy. “If you don't, somebody else is going to come in and ask, 'Has your broker told you about reference-based pricing?' 'No, he hasn't? I wonder why?'”
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Emily Payne
Emily Payne is director, content analytics for ALM's Business & Finance Markets and former managing editor for BenefitsPRO. A Wisconsin native, she has spent the past decade writing and editing for various athletic and fitness publications. She holds an English degree and Business certificate from the University of Wisconsin.
