Rbp Info Sheet

Listing Results Rbp Info Sheet

Frequently Asked Questions

• What is an RBP health plan?

  The company’s RBP health plan works together with employees to seek optimal care under this method and it helps cut costs at the same time. This method improves your reference based pricing plan strategy year over year. Employers who utilize RBP are not beholden to an arbitrary discount off of a hidden hospital ChargeMaster list.

• What is the future of reference based pricing for RBP claims?

  Payer Compass has seen “less than half of 1%” balanced-bill rates for over 1 million RBP claims. [ps2id id=’my-id-1’/] One Digital, a health care benefits advisory firm, also sees a strong future for reference based pricing in terms of letting the employer cut costs and reward the provider with a higher percentage than medicare.

• Who are the authors of the RBP document?

  Principal authors of this revision are Michael T. Barbour, James (Sam) Stribling, Jeroen Gerritsen, and Blaine D. Snyder. Many others also contributed to the development of the original RBP document. Special thanks goes to the original Rapid Bioassessment Workgroup.

• Why choose an rxrbp plan?

  RBP plans can steers patients toward a trusted, local provider by waiving member cost share if employees use that provider. This provides a solution for physicians’ desire to increase market share within their community and grow their business. Value is not found in complex relationships of three (employer, insurer, and physician).

• What is reference-based Pricing ?

  As health care costs increase, employers have been exploring new types of health coverage options, one of which is reference-based pricing (RBP). This method typically does not involve a traditional insurance carrier or provider network negotiating covered services for the plan.

• Does reference-based pricing work for employers?

  Reference-based pricing may work for some employers, but it’s important to consider all possible implications on your workforce and employees. It may also be helpful to consider alternative approaches that guide employees to the most competitive facilities in your network.

• What is the difference between reference based and transparent pricing?

  In contrast to a traditional reference-based pricing plan, these approaches limit disruption while still directing care to fair-price facilities. In one example, a member and the health plan saved over $20,000 through transparent pricing and proper member guidance.

• Can reference-based pricing be used as a comprehensive payment strategy?

  Only employer-based plans regulated under ERISA may use reference-based pricing as a comprehensive payment strategy. To date, most payers that have used reference-based pricing have limited it to out-of-network emergency and laboratory claims.