Reference-Based Pricing: A Fresh, Cost-Saving Alternative to PPOs

As you start researching your company’s health benefit plan options, don’t discount plans that feature Reference-Based Pricing (RBP).
 
Rather than using a Preferred Provider Organization (PPO) network for claims discounts and pricing, RBP plans use some other method on which to base medical claim reimbursements to providers.
 
Many plans, like Allied National’s RBP plans, use Medicare for its reference base. We reimburse physicians 125% of Medicare allowable and facilities at 150% of Medicare. This reimbursement level is often lower than many PPO networks but is still well above Medicare levels accepted by most providers. These savings immediately translate to lower premiums and lower out of pocket costs when you need care.

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