Health Insurance Cost Containment Strategies/Reference Based Pricing
Employers are driving a trend toward alternative healthcare cost management seeking reprieve from inflated medical pricing and PPO overpayment. It is apparent we are paying way too much for our care and Reference Based Pricing (RBP) is a solution growing exponentially in use that provides patients choice, saves employers money, and provides quality care. RBP may eliminate the need for a PPO.
RBP is used with level and self-funded health insurance plans. RBP works best with a defined benefit health insurance structure based on more economical reimbursement levels designed to be fair and reasonable to providers based on various pricing data sets such as Medicare.
Defined Benefits Structure refers to the dollar amount that an employer will set for medical procedures. Our cost containment partner, Advanced Medical Pricing Solutions (AMPS) negotiates with employers, physicians, hospitals, and out-patient facilities providing the most economical solutions and miniscule balanced billing for overcharges. AMPS solution Care Connex, brings pressures of consumerism and the free market to the medical world thus stimulating cost transparency. AMPS is an integral extension of your Group’s Benefits Team, providing proactive outreach, ongoing advocacy, advocate authorization and credit protection. AMPS online Care Navigator or HealthJoy, a Virtual Assistant mobile app are two other integral parts to make life easier for your employees.