Archive for December 11th, 2015

McAllen ISD Seeks Insurance Consultant

Friday, December 11th, 2015


McAllen Independent School District is accepting submittals on the following item: (more…)

City Draws Fire Over Health Plan

Friday, December 11th, 2015


“The hospital was forced to file suit against 10 individual patients. In the end, the insurance companies payed the requested amount, the individuals paid their out-of-pocket expenses and eventually the repricing company stopped the practice.”

Editor’s Note: This article does not tell the whole story and may be misleading. We called the city for more information and found this to be an interesting case study; City of Richmond eschews managed care contracts and instead implements a reference based pricing model for their self-funded health plan in a local one hospital town. Hospital pushes back hard, city stands firm and to this day continues to pay medical caregivers through their reference based pricing model. This is more evidence that Cost Plus / Reference Based Pricing will work only as long as the Plan Sponsor is “all in” and willing to take a stand.