There is a common denominator among us towards solving the high cost of health care to which we can all agree regardless of our political persuasions.
Back in 2007, 41 years after government mandated Reference Based Pricing for old people, nay sayers predicted Reference Based Pricing would never work. BUCA reps and their hospital partners circled the wagons with dire warnings to plan sponsors with the threat plan members would not be able to access care.
Then lawyers got involved, threatening lawsuits against anyone other than old people unless balance billing was paid in full, at full chargemaster rates that no one ever pays. Few brokers were willing to jeopardize their commissions under the influence of their BUCA agent contracts containing a 30 day termination clause without cause.
HR departments joined the chorus of nay sayers.
But a few early adopters persisted, joining all the old people who went before them with excellent results. Then middle adopters joined in. Now late adopters are edging towards the cliff of no return, almost ready, crawling ever so slowly, to jump off into shark infested waters where others have gone before including old people who made the plunge in 1966. Most of the sharks have vanished and the few left are toothless including more than a few old people.
Yet many continue to cling to PPO plans believing they have the best and nothing else will do. They believe cost increases are inevitable and there is nothing they can do about it other than passing more costs onto plan members. There is a growing sentiment among these timid souls that only government mandated Reference Based Pricing can control health costs. They believe Medicare For All is the ultimate, final solution.
Reference Based Pricing plans agree. They believe every Plan Sponsor should adopt Medicare For All reimbursement rates. That’s exactly what they have adopted, Medicare reimbursement rates but with a slight difference. They place a bonus payment on top of Medicare rates although we don’t know why. Old people don’t do that.
Plan sponsors adopting Reference Based Pricing didn’t wait for government help to do it so why wait for the government to mandate it when you can do it now? After all, isn’t that the final solution you’ve been hoping for? Isn’t that the solution you’ve been demanding? Isn’t it time to act? Or are you waiting to become an old person?
