Reference-based pricing (RBP), in which self-insured employers set a reasonable and fixed price for health services in their plan, has emerged as a rapidly expanding solution for companies that want to exercise more control over health care costs. To implement and administer RBP, employers are turning to experts like Benefit Administrative Systems (BAS), a division of HealthComp Holdings and a leader in RBP. BAS founder Marty Joseph will share his RBP expertise and insights in a session entitled Outlook on Reference-Based Pricing as a Cost-Saving Strategy for Employers and Brokers on May 1 at the Employer Health Care Cost & Quality Congress, part of the World Health Care Congress, in Washington, DC.
BAS is one of the first companies to venture into RBP plan administration and is recognized as a preeminent expert in the space. The company started its RBP administration services with two employer groups in 2013 and now works with more than 130 groups in 2019. These groups range in size from 100 to 12,000+ members. Since BAS first operated in this space, it has processed over 465K RBP claims, totaling over $400M in billed charges.
As health care costs continue to chip away at employers bottom lines, they are turning to RBP as a new and innovative approach to control costs, improve transparency, and ensure quality health benefits for employees, said Joseph. Through our experience in administering a high volume of RBP claims and in collaboration with our RBP customers, weve designed unique RBP programs that achieve employer goals to save costs and provide a superior member experience. Weve made BAS a dedicated Center of Excellence in RBP administration, exemplifying our specialization in and commitment to this model.
In regard to his session, Joseph added, Im excited at the opportunity to share my expertise at the upcoming World Health Care Congress in Washington, DC, where employers can learn about the RBP model “ what it is, how it can save them money, and the best practices to ensure success and member satisfaction.
Companies that administer RBP, such as BAS and RBP repricing vendors, have reported major savings for their employer clients “ up to a 25 to 30% overall reduction or an average savings of $150,000 per 100 employees in the first year. This benefit approach attacks the crisis of skyrocketing health care costs from multiple angles:
- Fair and consistent pricing. RBP plans aim to reimburse providers at a fair and reasonable price based on a set reference point “ such as Medicare rates or the actual cost of delivering the healthcare service.
- Transparency in pricing and billing. Line-by-line auditing of claims ensures cost transparency and avoids scenarios where employers may be overcharged for certain healthcare services or products, such as being billed $1,000 for a patient toothbrush.
- Customization. Employers can work with BAS and an RBP repricing vendor to customize their plan.
A major concern for employers and employees is balance billing, in which a facility may bill a member for the balance between what it receives from the plan and what it expects to be paid. BAS has developed unique programs that address this issue, as well as fostering overall RBP success:
- Initial and ongoing education, customer service, and support help members always know what to expect and how to engage with their benefits.
- Deep expertise and experience with common challenges enables BAS to offer proactive strategies to address them. BAS offers an outreach program that alerts members with a text and live phone call when an RBP claim is processed. As a result, these members understand the steps they need to take if they receive a balance bill.
- BAS ensures a seamless member experience through integration with the repricing vendor and member advocacy programs, both of which minimize confusion and frustration.
- BAS also provides data and reports on claims and demographics, so that employers can better manage their groups overall needs.
Employers interested in attending can register via the World Congress site:
About Benefit Administrative Systems, LLC (BAS)
BAS, a division of HealthComp Holdings, is a results-driven third-party administrator that was founded in 1983. The company has a track record of delivering cost savings and customer satisfaction. It utilizes specialized services, tools, and partners to create a robust partially self-funded plan as unique as each client. BAS is headquartered in Chicago, Illinois.
About HealthComp Holdings
For more than 35 years, HealthComp Holdings has been dedicated to transforming benefits management into an experience that employees and employers love. Bringing together concierge-level service, operational excellence, powerful analytics and cost management, weve built a solution that integrates seamlessly with any benefits ecosystem. As one of the nation’s leading benefits administrators for self-funded employers, we are comprised of two Centers of Excellence: Our Center of Excellence for PPO administration is based in Fresno, California, and our Center of Excellence for Reference-Based Pricing (RBP) is based in Chicago, Illinois.
Joy Scott, CEO, Scott Public Relations