Another Third Party Administrator Touts Cost Plus Insurance – New Market Trend?

Moving away from managed care contracts is becoming a major trend of late. We are seeing more third party administrators entering into cost plus reimbursment strategies in an effort to reign in ever increasing health care costs for their clients. We have identified at least eight (8) TPA’s who are active in Cost Plus Insurance.

Now we find one more TPA active in the Cost Plus Insurance market – Payer Fusion:

“Our unique approach to claims reimbursement creates significant savings for our client partners while allowing providers a fair reimbursement based on the actual costs of service. Our unique Cost-Plus Pricing Methodology assesses each claim compared to national data reported by federal agencies. Utilizing this data we are able to determine the actual cost of service, needs of the provider to offset losses from Medicare patients and the fair retail cost of the service provided.”

https://payerfusion.com/ceos-blog/cost-plus-methodology

Editor’s Note: As was the case with the $3 hand calculator retailing for $100 in 1972, so goes the cost of administrating health care plans using cost plus strategies. Competition is a good thing.

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