he financial pressures around COVID-19 are creating a “buzz” among employers about a potential shift to reference-based pricing (RBP).
Under this model, an employer would not contract with a traditional payer but instead with a vendor who manages coverage set at a flat rate across providers, typically significantly higher than Medicare but less than would be paid under a commercial plan.
Andrew Halpert, M.D., senior clinical consultant at Mercer, told FierceHealthcare that interest in this type of coverage was more common among smaller firms, but midsize and larger companies are also expressing interest.
“It’s the economic straits in their businesses that is pushing plan sponsors to ask about this as one of an array of potential cost-saving strategies,” Halpert said. Read More: FierceHealthcare