Health care affordability remains a monumental issue, presenting a daunting fiscal challenge for individual consumers, employers, and public budgets alike. Skyrocketing health care costs have introduced roadblocks to essential health services and prompted a vigorous search for new and robust strategies to mitigate this escalating crisis. 

More than any other development in my 21 years in this industry, reference-based pricing (RBP) has emerged as one of the most compelling and progressive approaches to this challenge. This innovative model, championed by disrupting self-insured employers, defines a maximum limit or “reference price” they’re willing to pay for health care services. Different repricing entities use varying metrics, but this often ties the claim payment to a derivative of Medicare that results in the employer paying from 140% to 150% of Medicare, on average.  

Opaque pricing shrouds the legacy health care sector. The actual costs of services have historically remained elusive for both patients and payers, often only disclosed post-provision. This murkiness precipitates pricing inconsistencies, engenders inefficiencies, and cultivates an environment ripe for bloated costs and rampant fraud.

Complete your profile to continue reading and get FREE access to BenefitsPRO.com, part of your ALM digital membership.

Your access to unlimited BenefitsPRO.com content isn’t changing.
Once you are an ALM digital member, you’ll receive:

  • Critical BenefitsPRO.com information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and BenefitsPRO.com events.
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com

Already have an account?


NOT FOR REPRINT

© 2023 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.

BenefitsPRO Broker Expo 2024Event

The premier educational and networking event for employee benefits brokers and agents.

Get More Information
 

BenefitsPRO

Join BenefitsPRO

Don’t miss crucial news and insights you need to navigate the shifting employee benefits industry. Join BenefitsPRO.com now!

  • Unlimited access to BenefitsPRO.com - your roadmap to thriving in a disrupted environment
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com
  • Exclusive discounts on BenefitsPRO.com and ALM events.

Already have an account? Sign In Now
Join BenefitsPRO

Copyright © 2023 ALM Global, LLC. All Rights Reserved.