El Paso ISD uses the CIGNA PPO network. Other districts nearby use Aetna and Blue Cross. Of the three networks, which one offers the best prices?
There are obviously three opinions here. There can only be one that’s right. That means one of the three PPO networks wins and the other two lose.
Since claim costs represent 90% of a plan’s spend, it makes sense to select the network with the best discounts. Trouble begins when the network and their health care partners set the starting point. A 50% discount off double the price beats a 60% discount off triple the price.
This top down approach has never worked out too well.
A bottom up approach makes more sense. That’s why Reference Based Pricing is capturing the attention of plan sponsors across the country.
NOTE: Video is time stamped. Short 7 minute insurance presentation. Plan contributions for El Paso vs surrounding districts shown 1:29:19.