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Cutting Healthcare Costs Through Reference-Based Pricing

Posted on by Ashley McCurdy

Calculator atop of paper financial statement

Cutting Healthcare Costs Through Reference-Based Pricing

As healthcare costs continue to rise, pricing transparency is becoming a bigger demand from employers. For years, the actual costs of healthcare have been vague and virtually inaccessible to employers; however, now they’re becoming more available through reference-based pricing.

Reference-based pricing plans enable employers to pay a defined amount for certain healthcare procedures. This amount is typically a percentage more than what the Medicare pays for the same procedures.

Through reference-based pricing plans, employers can save on employee healthcare in three key ways:

  1. By paying a percentage more than the Medicare price, employers no longer pay grossly overpriced claims, as is typical in a PPO plan.
  2. In many cases, reference-based pricing plans reduce or eliminate PPO access fees.
  3. By using a TPA to manage reference-based pricing plans, employers can reduce the amount of administrative fees that they would otherwise pay to a carrier.

When working with BMA, employers receive personalized guidance about how to best structure the reference-based pricing plan for their employees. They will also receive educational materials and communications that will help employees understand and make the most out of their reference-based pricing plan.

BMA’s reference-based pricing plans help employers achieve greater transparency in their claim spend, encourage wiser healthcare choices through employee cost sharing, and ultimately increase cost savings for the employer.

Contact us for an assessment of how reference-based pricing will give your company better cost transparency and more healthcare savings.

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