Reference-based Pricing is Gaining Momentum - Here's Why

Healthcare and pharmacy costs continue to rise. We have focused on the wrong issue. We don't have a healthcare issue; we have a billing issue.

Reference-based pricing attacks the problem - targeting billing. Here's how it works - typically, a preferred provider organization network achieves a 50-60% discount on billable charges. However, after this 50-60% discount, the cost of care is still double or triple what Medicare pays for the same service. For example, the same cholesterol blood test can range from $10 to $400 at the same lab. The same hospitalization for chest pain can range anywhere from $3,000 to $25,000. Reference-based pricing allows employers to pay for medical services based on a percentage of CMS reimbursements (i.e. Medicare + 30%), rather than a percentage discount of billable charges. This model ensures that the above-mentioned hospitalization cost an employer $3,000 rather than $25,000. ur text here ...

As such, referenced-based pricing is becoming increasingly popular and we are prepared! We have several carriers that offer reference-based pricing: Allied, Starmark and HealtheChoices.

Please contact This email address is being protected from spambots. You need JavaScript enabled to view it., ext 208, or This email address is being protected from spambots. You need JavaScript enabled to view it., ext 216, to learn more.

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