Industry: Food prep
Reduced claim costs by over 30%, or $300 per employee per month
Reference-based pricing is an innovative way for employers to help control healthcare spend and give their members the freedom to see the provider of their choice under their self-funded health benefit plan.
With reference-based pricing, reimbursement is based upon a fair percentage (typically 150% or 200%) of a cost-based metric or what Medicare pays for a particular service instead of a discount off of the medical facility’s Chargemaster price, which is what happens with a PPO plan.
Because there’s no PPO network with reference-based pricing solutions, members can go to any provider of their choice for the care that is subject to reference-based pricing under their plan.