“How We See It- Industry Updates”

The verdict is in: Colorado Court Ruling Supports Reference-Based Pricing

The Referenced-Based Pricing (RBP) reimbursement model in health insurance (does not include Rx, by the way) is an evolving self-insured plan/claim cost control model that has been in the market in various forms for about a decade. While there are some true believers in this pioneering pricing model, others fear the possible repercussions from the healthcare delivery side (i.e., provider backlash). However, a recent July State of Colorado District court ruling has been a win for those in support of an RBP approach for their healthcare benefit plans.

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IMA Financial
June 9, 2018