“We have encountered resistance with RBP service providers that base their fee on a percentage of billed or savings…………………..”
I think some of the RBP service providers are conflicted on the direct contracting issue primarily because their revenue is eroded when a direct contract is engaged. I agree that RBP is a natural bridge to direct contracting and alternative reimbursement arrangements as it opens up awareness and informed dialogue between employers and providers. However, we have encountered resistance with RBP service providers that base their fee on a percentage of billed or savings when their role changes from pricing an allowable where a contract does not exist to pricing an allowable when a contract does exist. In my mind it is difficult to justify paying any service provider on a percentage of anything to begin with, but is really pushing the envelope when a direct contract is in place.
The second issue that is a bit confusing is RBP organizations that will contract on behalf of their clients, but only if they hold the contract, not the plan sponsor. If the concept of disintermediation and transparency is to place the plan sponsor as the master and all service providers as the servant, creating another intermediary relationship doesn’t seem to make a lot of sense going if the goal is to achieve true Transparent Medical Markets.
One thing for sure is the market is fluid and evolving quickly.
Senior Vice President
USI Consulting Group
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