This is what can happen when Reference Based Pricing plans capture market share…………….
By Bill Rusteberg
Valley Baptist hospital in Harlingen, Texas has been accepting Reference Based Pricing plan patients for many years. Balance billing has been few and far between. Area Reference Based Pricing plans have been paying 120% of Medicare and in some instances less than that.
Less than a mile away Harlingen Med. Center competes for business. That hospital has entered into direct agreements at 130% of Medicare. No outliers.
Effective June 2026, Valley Baptist has entered into a direct agreement with an area employer at 120% of Medicare. No outliers.
