Navigating the Wild West of RBP

Ever imagine healthcare could feel like the Wild West?  Welcome to the untamed lands of reference-based pricing (RBP), the sizzling frontier where a select few employers unleash radical savings while giving the traditional PPO system a stiff arm.

Unveil a world where only 3% to 4% of employers dare to tread, but where jaw-dropping 30-40% savings rain like gold and concierge-level service is the sheriff in town.

Curious about RBP’s magic? This isn’t just health care. It’s “Health-FAIR!” Here, employers “price-match” medical costs against benchmark prices, slicing their claims in half compared to big insurers.

Projections say employer healthcare costs will shoot up another 7-9% in 2024. Yet Medicare Part D Premiums are projected to decrease by 1.8%.  All major insurers participate in both markets.  The lesson?  Employers with private insurance are subsidizing Medicare.  But hold your horses. With RBP, brace yourself for a 0-2% trend that turns the tables on traditional care.

Jump into this roller-coaster ride of a podcast with your guide through this maze, joined by two titans of the trade—Omar Arif of ClaimDOC & Scott Schnaidt of HST.  They’ve both cracked the code, each in their unique ways, and the results? Nothing short of spellbinding.

What’s on Tap:

• The gears and levers behind RBP
• Navigating the legal minefields
• Secrets from Third-Party Administrators (TPAs)
• RBP’s performance across the geographical board
• The art of handling balance bill claims
• Litigation: When & How Often
• Co-fiduciaries: The real deal or just smoke and mirrors?
• Show Me the Money: Their pay structure dissected
• Year-end Report Cards: The Good, the Bad, and the Profitable

And just when you think it couldn’t get any cooler—did one of these guys actually play pro baseball in a global tourney, while the other rocked the stage with Nirvana?