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Reference-based pricing reimbursements: When to negotiate

There are pros and cons of negotiating prior to an employee’s surgery or service, versus after the surgery or service. Here are a couple of things to consider.

By Alex Tolbert | April 22, 2019 at 01:39 PM
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One of the biggest concerns around reference-based pricing for brokers and employers alike is the potential that employees may be balance billed.

Often, the argument goes something like this: With no negotiated rates, hospitals are just throwing the chargemaster price at employees, who are effectively left uninsured and staring down thousands, or hundreds of thousands, of dollars in medical bills.

Who wouldn’t stay fully-insured after hearing that? What broker wants to present that strategy to a prospect?

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