RBP Vendor Embraces PPO Strategy

A case of Wanting His Cake and Eat It too……..A half pregnant attempt towards solving health care……………….

Reference Based Pricing vendors compete with each other every day. Their method of distribution is the brokerage community largely made up of status quo brokers who do business the old fashion way. RBP vendors court the same brokers for business. It’s a competitive business.

In the beginning RBP vendors sought out those renegade brokers / consultants who were not afraid to step away from status quo solutions to rising health care costs and into the shark infested waters of RBP. There were not too many of those out-of-the-box types, a limited distribution network.

Now we are seeing RBP vendors aggressively seeking out status quo brokers who heretofore were adverse to the perceived perils of RBP strategies. Rather, these formerly RBP puritans are taking the Tip-Toe-Through-The-Tulips approach to winning over brokerage business.

These days a RBP vendor is either a Half Pregnant Tulip Lover or Cliff Dweller.

“My clients will never do this unless there is a Safe Harbor network available!” cry the brokers. We must have a Half-Pregnant RBP plan or it won’t sell!”

It’s stranger than fiction! It appears the RBP vendor wants His Cake And Eat It Too.

AMPS and PNOA Form Strategic RBP Partnership

MyHealthGuide Source: Advanced Medical Pricing Solutions (AMPS), 6/21/2021

ATLANTA – Advanced Medical Pricing Solutions (AMPS), a pioneer in healthcare cost containment, and Provider Network of America(PNOA), a direct-contracted provider network with a presence in all 50 states, announce expansion of their strategic partnership in the reference-based pricing (RBP) sector. Through the holistic PNOA Network, AMPS’ members will have exclusive access to the country’s top medical professionals.

After successfully piloting the integration between AMPS’ cost-containment platform and PNOA’s contracting engine, AMPS validated that when members were seeking care they achieved deeper savings, expanded their provider access, and encountered a better member experience. AMPS and PNOA have agreed to further integration and promotion that will provide AMPS self-funded, healthcare sharing, health system, and health plan clients with access to PNOA’s network of providers that accepts fair pricing for encounters.

“PNOA is thrilled to expand its partnership with AMPS to now actively promote access to our growing number of contracted providers to groups adopting reference-based pricing,” stated Mark Dyer, CEO of PNOA. “Through this strategic partnership with AMPS, a leader in the RBP market, PNOA will have a channel to help more families gain access to our growing network of cost-conscious providers.”

The combined offering from PNOA and AMPS, available immediately as an option to AMPS clients, enables members access to more than 2,500 hospitals, 25,000 ancillary facilities, and 525,000 providers nationwide. This strategic partnership, along with the AMPS Care Navigation team and the AMPS Connect mobile application, will allow for better pricing, less provider pushback, and improved member experience for groups adopting RBP.

“By partnering with PNOA, AMPS clients gain access to the fifth largest network in the U.S., which is expanding each and every week with high-quality medical providers and other medical services,” notes Kirk Fallbacher, AMPS president and CEO. “The partnership allows us to gain access to providers best suited for all our clients and their members, which helps AMPS fulfill its mission to make healthcare dollars go further.”

About Advanced Medical Pricing Solutions (AMPS)

Advanced Medical Pricing Solutions (AMPS) provides market leading healthcare cost containment solutions serving self-funded employers, brokers, TPAs, health systems, health plans, and reinsurers. AMPS mission is to help clients attain their goals of reducing medical and pharmacy costs while keeping members satisfied with quality healthcare benefits. AMPS leverages its 15+ years of experience and data in auditing and pricing medical claims to deliver “fair for all” pricing. AMPS offers detailed analytics and transparency to provide clients with insights based on plan performance. Visit amps.com.

About Provider Network of America (PNOA)

Provider Network of America (PNOA) is a nationwide, directly contracted provider network. With a presence in all 50 states, PNOA has achieved aggressive discounts with all provider types in an effort to service its large membership base. PNOA offers national PPO network access, narrow network access, Medicare driven reimbursements, custom network development and timely repricing to its clients. Visit pnoa-ppo.com.