Reference Based Pricing Video

Reference Based Pricing - The Solution to Cost Savings AND Transparency

Self Insured Plans offers Reference Based Pricing to employer groups – a medical management strategy designed to reduce health care spending by the employer, while also engaging the health care consumer. Under reference based pricing, a plan pays a fixed amount for a certain procedure and contracts with providers who agree to accept that fixed amount as full payment. Plan enrollees are driven to use a provider that has agreed to accept the fixed amount, but if the plan member chooses a health care provider that charges more, he or she must pay the difference out-of-pocket.

Reference Based Pricing Encourages:

  • Providers to learn more about the prevailing costs of health care services
  • Consumers to review pricing information in advance
  • Both plan members and providers to take initiative in learning the true costs of health care services and avoid the substantial variations in pricing that can exist

These improvements are sure to open the door to savings and to simpler, more transparent health care pricing.

sip reference based pricing


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