May 2022

Reference Based Pricing, Simplified

5/3/2022 2:47:03 PM

WEBINAR: Reference Based Pricing, Simplified

Wednesday, May 11, 2022
1:00 pm EDT
30 minutes


Plan sponsors are always looking for new ways to manage the cost of providing benefit plans while maintaining high member satisfaction. Reference Based Pricing (RBP), which reimburses hospitals and facilities based on a percentage of Medicare, offers an effective way to rein in hospital costs, but leaves the plan responsible for physician and ancillary charges. Members also often find the healthcare system complex to navigate, creating further dissatisfaction.

SmartDecision, HealthSmart’s approach to Reference Based Pricing (RBP), offers a unique alternative.  

Our concierge hosts help members navigate the health system, which contributes to a less stressful member experience and to higher compliance with treatment recommendations. Our program nets significant discounts on facility services while national PPO networks manage the costs of professional and ancillary charges. Members are always protected from surprise bills and unexpected charges for the covered services they need. 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 and Kevin Glass, VP of Business Development for HST,  will discuss how providing a superior member experience combined with industry-best benefits administration can change the frame of reference from pricing to value. 

Attendees will learn:
  • How a Reference Based Pricing program compares to traditional PPO networks
  • How SmartDecision protects members from balance billing, collections and credit issues across their RBP program
  • How a comprehensive concierge approach to managing the member experience improves satisfaction while reducing benefit costs
  • How bundled pricing for non-urgent episodes of care, inclusive of facility, professional and ancillary fees creates higher value for self-funded plans in select coverage areas
  • How pricing and quality transparency matched with technology and clinical judgement deliver overall average savings of 70 percent or more from billed charges; and
  • How industry-leader HST’s services combine with HealthSmart’s SmartDecision program to create greater value than conventional approaches to RBP