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.
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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?
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