Reference-based pricing: What about balance bills?

Posted by Emily Kubis on Wed, May 09, 2018 @ 08:05

Solutions for employers

Reference-based pricing is a new way for self-insured employers to pay for employee’s medical costs. Instead of using a traditional insurance carrier’s network, employers simply pay hospitals a percentage in excess of Medicare’s reimbursement rate for the same service.

Why would employers adopt this plan?  Generally, the benefit that insurers provide to employers are their network discounts for services. But with healthcare prices skyrocketing, employers are questioning whether this strategy provides enough value.

(More: How a 40-employee group saved $100,000 with reference-based pricing.)

Here’s how hospital pricing usually works.

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Tags: health insurance small employers, Self-Insured, self-insurance, self-funded, reference based pricing, balance billing

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employer healthcare freedom
employer healthcare freedom