AEE17: Employers and Reference-Based Pricing—David Contorno's Latest Thinking

Oct 5, 2021

9:20

Episode Description

In this An Expert Explains episode, Stacey Richter talks with David Contorno, founder of E Powered Benefits, about employers and reference-based pricing (RBP). David explains how reference-based pricing actually works — employers paying providers some percentage over a reference point like the Medicare rate — and how to do it in a way that avoids the balance-billing problems that have given RBP a bad reputation.

WHAT YOU'LL LEARN

✅ What reference-based pricing (RBP) actually means, and how employers typically set a percentage over the Medicare rate

✅ Why RBP has gotten a reputation for balance bills, and how to structure it so that doesn't happen

✅ What pricing methodology 97% of healthcare is actually using

✅ Why hospitals have multiple revenue streams, and why the commercial rate is consistently the highest of them

✅ How E Powered Benefits has worked to minimize the noise and confusion around reference-based pricing

WHY THIS MATTERS

Very few people really recognize that hospitals have multiple revenue streams — and of those streams, commercial is consistently the highest price. Reference-based pricing done right doesn't have to result in balance bills for employees; the problems show up when it's done without the right guardrails in place.

=== LINKS ===

🔗 Show Notes with all mentioned links: Episode Page

🔗 Healthcare Industry Acronyms and Terms

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00:00 Introduction

01:37 What does good reference-based pricing look like?