Common sense dictates that medical caregivers who accept Medicare pricing should have no problem accepting Reference Based Pricing plans that uses the same pricing.
There are thousands of HOSPITALS accepting Medicare payments on behalf of patients so Medicare pricing appears to be fair and reasonable. After all, medical providers don’t have to participate in the Medicare program. No one is forcing them to participate.
A commercial health plan paying 100% of Medicare does not need deductibles, co-pays or other barriers to health care. Instead the plan can simply pay an identical Medicare indemnity amount for each service provided.
If medical caregivers want more than what the plan pays, the patient can choose to pay the additional cost or find a more willing provider who will accept the plan’s payment as payment in full. The law of supply and demand will work in favor of willing participants on both sides of the purchasing transaction.
Will this strategy work in the private sector? The answer is yes, of course it will. Recently a large national self-funded employer adopted this strategy so the idea is beginning to catch on. Its all about Accessing Medicare’s Provider Network.
