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Reference Based Pricing

Reference Based Pricing/ (RBP)- a reimbursement calculation utilizing the Medicare allowance and mark up value; a reasonable level of reimbursement to medical professionals.

Reference-based pricing (RBP) is rapidly gaining in popularity as a method to help clients control healthcare costs.

 

The main problem of RBP is the impact on employees. When they are not well-educated on their specific plan or guided to appropriate providers, the consumer can be left to pay the difference between the reimbursement maximum and the provider’s charge (a practice known as “balance billing”). When the employee is smacked with thousands of dollars in medical bills, such cases negatively impact the employer as well.

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