JANUARY 18TH, 2022
Reference-based pricing is a powerful tool for employers that can help you and your employees reduce costs while improving healthcare options. It essentially pays providers a percentage of an established benchmark — often reimbursing based on Medicare pricing — rather than a traditional negotiated rate. But before you jump in, it’s a good idea to take some time to figure out the best way to implement it to support your team.
One of the benefits of a well-structured reference-based pricing plan is that it can help reduce or eliminate the likelihood that balance billing could damage your employees’ wallets or well-being. In turn, this improves their productivity and your company’s bottom line — so everyone wins!
First, you should be aware that not all reference-based pricing strategies are created equal. There are plans designed to eliminate the need for networks, plans created to fill the gaps where coverage lags for out-of-network providers, and plans that provide benefits only for certain procedures. Take some time to research the best option for your team. You might consider reaching out to an expert who can help you figure out which plan best meets your unique needs.
Once you’ve decided on the best model for your company, you’ll need to do a lot more than simply implement your new plan. Reference-based pricing options are new territory for many people, and it’s essential to provide adequate education to make sure your team understands exactly how they can get the most out of the package you offer. Employees need to understand the tools and information at their disposal to use them.
Ongoing education and support of your team across multiple channels will ensure everyone benefits from your new plan. You can accomplish this by including regular information in company newsletters or communications, providing individual support for employees with questions, and hosting companywide training sessions.
Your annual open enrollment period is a great time to set up one-on-one sessions between educators and your employees to let them ask questions and help them make cost-effective choices. You can also create reference material in print for your team to review throughout the year.
You will need to plan to support employees during critical moments, such as when they enroll in a plan, search for care providers, or work to resolve billing questions. Depending on the needs of your team, you might plan to provide this support in-house or contract the services of a benefits advocate.
If reducing balance billing is one of your top goals, you must provide more robust education for your team members. It will help them better understand how the healthcare system works while also providing them with more insight into reference-based pricing options. You might also want to make transparent pricing guides — covering providers in your area — available for employees to help them make educated healthcare decisions.
Done correctly, a switch to reference-based pricing can help you foster a healthier and more empowered team. And the best way to ensure that happens is to take the time to find the best reference-based pricing option for your company and provide plenty of support to your employees as you implement the new strategy.
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