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Reference-Based Pricing

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

Benefit Design Specialists, Inc.

BDS offers a range of services and products dedicated to a two-fold goal; delivering quality, cost-effective employee benefit plans coupled with hassle-free benefits management for our clients HR departments.

1 Kacey Court, Suite 100
Mechanicsburg, PA 17055

Toll Free: (888) 273-7036
Phone: (717) 766-8844
Fax: (717) 766-8711

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