Zelis Reference Based Pricing

Plan sponsors face tough choices when trying to balance plan savings, member satisfaction and provider abrasion. 

Traditional RBP strategies will typically protect the plan but not the member, and sometimes force plan sponsors to choose between savings or member satisfaction. Plans directed toward member satisfaction will favor access to providers, usually at higher reference prices. Plans designed for more cost control will set lower reference prices, saving money for the member but making it more likely that members will travel further for a physician or incur balance billing.

This white paper offers insights into using Reference Based Pricing as part of a balanced and comprehensive cost management strategy that balances the needs of all stakeholders: payers, plan sponsors, members, and providers.


To read the full White paper, fill out the form below.

Healthcare Focus