Blog // HealthSmart Blog // July 2021

WEBINAR: Creating Value Beyond Reference Based Pricing

7/26/2021 12:42:43 PM

WEBINAR: Creating Value Beyond Reference Based Pricing

SmartDecision: HealthSmart’s Approach to Reference Based Pricing 

 Reference based pricing refers to a network of hospitals and other facilities that accept reimbursement based on a percentage of Medicare basis, rather than discounts from billed charges, as most PPO networks function. HealthSmart offers a comprehensive alternative to traditional RBP programs. Our concierge hosts help members navigate the health system, which contributes to a less stressful member experience and to higher compliance with treatment recommendations. We also offer a bundled approach to non-emergency procedures that includes both facility and professional fees to provide high quality care with no deductibles for members and no balance billing in several markets.
In this webinar, Craig Julien, EVP, TPA Operations for HealthSmart  will discuss the advantages of using a network of providers compensated based on Medicare pricing rather than provider charges. 

Attendees will learn:
  • How a Reference Based Pricing network compares to traditional PPO networks;
  • How SmartDecision protects members from balance billing across their RBP network;
  • How bundled pricing for non-urgent episodes of care, inclusive of facility, professional and ancillary fees create higher value for self-funded plans in select coverage areas; and
  • How pricing and quality transparency matched with technology and clinical judgement deliver overall average savings of 70 percent or more from billed charges