Not all RBP is the same. There are various vendors operating in this space and there are nuances that must be considered. The below are random thoughts on the passing scene, a free-thought list if you will…
A proactive cost-plus approach is far better than a reactive one. Pay and litigate later is an expensive let alone exhausting way to do business.
Much success is achieved when people come together to talk, not many will argue the desire for fair and transparent pricing.
Who is going to advocate and educate the consumer?
Who is going to educate the front-desk/intake clerk at the doctor’s office who’s never seen this logo on an insurance card before?
Look at the fees - are you paying a % of the billed claim or of the savings off of the billed claim? You’re wasting your money if you are.
Are you philosophically on board with this concept? If the only goal is to cut costs, tread lightly.
Balance bills aren’t always a bad thing
If someone tells you they can eliminate balance bills from occurring run for the hills.
Even in the world of PPO networks, patients see balance bills as often as 40% of the time.
RBP is just a tool. It’s not an end point. The goal is to continuously disintermediate. Directly paying for the services being used.
The care team is critically important in the equation. The right RBP structure benefits all parties involved, including the care team.
Reference pricing by its vary nature should vary across markets and sometimes sub-markets.
Paying less for healthcare, cutting out the fat, is a large part of the problem. However, over-utilization is equally critical. Reference Based Pricing has no way of addressing this.
