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Is Reference-Based Pricing a Cost-Cutting Tool for Employers?
Cost-caps for health plans are gaining popularity. A relatively new solution to controlling health plan expenses, Medicare reference-based pricing (RBP), has been buzzing among employers and advisers alike. Referral-based pricing from Medicare lets employers save too, allowing them to control short- and long-term health care costs. In spite of all the buzz about reference-based pricing,…
Enhance Administrative Efficiency with TPA Medicare Claims Repricing
With the centralization of their workflows, third-party administrators can save significant amounts by replacing manual procedures with automated ones. So, TPAs can re-price all commercial claims at Medicare rates (Reference Based Pricing) at a percentage of Medicare allowable, as well as price all Medicare claims. SaaS-based CMSPricer’s Medicare claims repricing platform optimizes clinical, financial, and…
Aspects to Consider When Taking Advantage of Medicare’s Prospective Payment System (PPS)
In a time when healthcare costs are rising at an alarming rate, prospective payment systems (PPS) are one of the most important policy tools. Using a methodology that shapes providers’ incentives, PPS has gained traction in health policy-making in relation to the government’s effort to expand health coverage. How does PPS Work? Patient care is…