7 Reference Based Pricing Guarantees

By Molly Mulebriar

Believe it or not, most consumers and plan sponsors don’t know anything about Reference Based Pricing strategies and those that think they do have all kinds of misconceptions.

For example, during a recent board meeting the HR director gave a presentation on their upcoming health insurance renewal. When asked if she had investigated a Reference Based Pricing option her immediate response was “No, that’s for employers who don’t care about their employees!”

So let’s examine the truth and determine what guarantees Reference Based Pricing strategies bring to health care financing:

  1. No one is ever denied access to health care
  2. Balance billing occurs less than 2% of the time, lower than PPO plan balance billing
  3. Health insurance costs average 15-45% less than traditional plans
  4. Rate increases are rare – not unusual for rates remain stable over multi-year period
  5. Benefits are usually better than under traditional PPO plans
  6. Plan savings means more take-home pay for employees
  7. Professional providers embrace Reference Based Pricing plans and hate managed care plan

Based on these truths, “Employers who don’t embrace Reference Based Pricing plans don’t care about their employees!”

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