Reference Based Pricing

 

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TREAT YOUR MEDICAL COSTS IN THE SAME MANNER THAT YOU WOULD ANY OTHER BUSINESS COST

Key Advantages of Reference Based Pricing

- Reference Based Pricing (RBP) sets payments to healthcare providers based on the amount Medicare pays for the same procedure (Medicare Allowable plus 25% to 75%)

- Realize $150,000 average savings per 100 employees in year one

- Employees & dependents have access to online cost and quality transparency tools that offers a healthcare provider shopping experience similar to other online retailers such as Amazon

- Both the healthcare provider and plan members know the reimbursement payment before services are performed eliminating post-service negotiations and protects members from balance billing and collections

- No hospital networks to be concerned with – Employees can go to any hospital of their choice

- (RBP) Reference Based Pricing is compliant with Affordable Care Act rules and regulations

Example Claim Profile:

rbp-graph-final*Source: (HMA) Hawaii Mainland Administrators – Precis Plan

 

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