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Reference-based pricing (RBP) works. This self-insured model brings a rational approach to employer-sponsored health care by leveraging the actual cost of a service and basing reimbursement on a fair margin above that cost. In doing so, RBP provides reasonable payments to medical providers and delivers significant savings to employers, who can save anywhere from 20% to 30% of their total health care costs.

And yet, at a time when costs are expected to climb, and organizations are seriously in need of better health care options, some companies are reluctant to leave their traditional plans behind.

Companies that have been providing RBP solutions and member support to health plans over at least the past 10 years have been collecting unique and valuable data. Now, these companies are on the precipice of delivering more advanced RBP solutions by harnessing the power of artificial intelligence (AI) to positively impact member experience.

 

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