Barriers to RBP Plans

“Few employers are using reference-based pricing (RBP) benefit design, even though there is broad awareness of its potential for delivering savings,” according to a qualitative study published in the February issue of The American Journal of Managed Care®. “Evaluations of US RBP programs have found reduced spending between 13.9% and 31.0% for joint replacement surgery, … Continued


Presently, Medicare pays only for emergency ground ambulance services when patients are transported to hospitals, critical access hospitals, skilled nursing facilities, and dialysis centers. Most Medicare beneficiaries are thus transported to one of these facilities even when a lower-acuity destination may be more appropriate. Based upon a White Paper by the U.S. Departments of Health … Continued