Reference-Based Pricing
American Employers pay the highest healthcare costs in the world. And yet, as providers and insurers handle the bills in a black box, they mostly remain in the dark about why those costs are so high and have limited resources available to combat them.
At BDS, we deliver transformative healthcare savings for our clients by helping them achieve the same fiscal discipline they have in all other areas of their business.
Examples of RBP:
| Line Item | PPO | RBP | Annual Savings |
|---|---|---|---|
| Claims: | $2,896,377 | $2,519,840 | $376,537 (13% savings) |
| Stop Loss: | $791,677 | $574,018 | $217,659 (28% savings) |
| PPO Fees: (PEPM) |
$15.67 | $5.05 | $29,311 (67% savings) |
Client Profile and Situation
- 230 Employee multi-state self-funded group
- Based on 12 months of paid claims
- Utilized a BUCA Network (Blue, United, Cigna, Aetna)
- No benchmarking data or R&C (UCR) language
| Line Item | PPO | RBP | Annual Savings |
|---|---|---|---|
| Claims: | $13,075,564 | $10,291,407 | $2,784,157 (21% savings) |
| Stop Loss: | $5,029,063 | $3,958,234 | $1,070,829 (21% savings) |
| PPO Fees: (PEPM) |
$13.95 | $4.55 | $183,751 (67% savings) |
Client Profile and Situation
- 1,629 Employee multi-state self-funded group
- Based on 12 months of paid claims
- Utilized a BUCA Network (Blue, United, Cigna, Aetna)
- No benchmarking data or R&C (UCR) language
