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Around 85 – Business Seminar – Hendersonville – March '19

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Hendersonville, NC 28792

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Reference Base Pricing - The Good, The Bad & The Ugly

As employers and State Associations search for opportunities to save on healthcare costs, many are inquiring as to what are the promises and pitfalls of reference-based pricing (Medicare Plus)?

A popular focus for employers has been eliminating high-cost providers from networks or either through direct contracts with providers. This process, known as narrowing networks, is making a name for itself in the self-funded benefits community and among employers in both Carolina’s. The most aggressive cost saving trend currently being consider by employers is the potential savings gained through narrowing networks is reference-based pricing. This strategy all but eliminates the traditional “network,” driving savings (25%-35%) for employers and employees as they agree to pay a certain percentage above Medicare price for healthcare services.

Due to the complexity of these plans and the potential pitfalls, successful implementation requires careful planning. When considering a reference-based pricing plan, choose a vendor with experience, as well as clear, transparent processes and safeguards in place to protect your employees. Make sure that proper planning is conducted up front—such as holding conversations with highly utilized providers—to minimize potential disruptions.

Reference-based pricing may work for some employers, but it’s important to consider all possible implications on your workforce and employees. It may also be helpful to first consider alternative approaches that guide employees to the most competitive facilities in your network – direct contracts, bundled payments, direct primary care, transparent PBMs and Captives.

Those that register by the February 28th, you will recieve an email requesting some Medical and Pharmacy data. If you chose to provide that data, we will have a cost analysis completed and present this to you at the event.

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Hendersonville, NC 28792

Refund Policy

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