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Reference-Based Pricing Model is Disrupting Healthcare Models: Who Benefits?
Healthcare cost containment has changed forever with reference-based pricing (RBP) – although it has come with a lot of disruption. In addition to saving companies a lot of money, reference-based pricing impacts employee satisfaction.Self-funded healthcare refers to employers taking care of their own claims rather than paying for premiums through a carrier. Third-party administrators (TPAs)…
How to Take Advantage of Medicare’s Prospective Payment System (PPS)
A prospective payment system (PPS) is an important policy tool at a time when healthcare costs are rising alarmingly. In relation to the government’s effort to expand health coverage, PPS has gained traction using a methodology that shapes providers’ incentives. What is PPS and How Does it Work? Through the Prospective Payment System, patient care…
Repricing Medicare Claims Tool Can Increase Pricing Transparency for Healthcare Providers
In the healthcare industry, pricing transparency and accuracy have long been problematic, causing confusion and frustration for patients. The recent CMS report, however, highlights the efforts hospitals and health systems are making to implement price transparency policies. Based on CMS data, 70% of hospitals in 2022 complied with both shoppable service information display requirements and…