Tips for a Smooth Transition to Metric-Based Pricing

Reference-based pricing, also known as metric-based pricing, is a perfect alternative to the traditional PPO model which offers substantial cost saving & benefits for self-funded employers by leveraging the fair and transparent practices.

If you are not familiar with the metric based pricing healthcare, it could be disruptive to your operations to make the changes.

However, many self-funded employers are implementing this alternative to reap the benefits.

Referenced-based pricing is a modern solution for self-funded employers, which help in managing healthcare costs for their business & employees.

Under this model, reimbursements to the providers are based on the

actual

cost

for

delivering

service

or

Medicare

reimbursements. This more level approach starts at the bottom and adds a fair profit margin. Working with a reputable solution provider, self-funded employers can save up to 30% in the first year after switching to metric-based pricing.

Here are the tips for a smooth transition to a metric based pricing healthcare without disruption.

Employers should choose the partners that are trusted and have experience with providing successful reference-based pricing solutions.

Look for a provider that has a good number of years of experience, shares case studies from successful partnerships and retains their clients for a long-term.

Request to see the operations of the provider in-person to assess if the provider is financially secure, is equipped with resources & demonstrates a commitment towards the success of their clients.

Look for a partner who welcomes site visits and pay specific attention to the size of the customer service team.

Your metric-based pricing solution provider should be a partner that is 100% invested in the success of your business.

Look for a partner who’s willing to sign on as a co-fiduciary as it may be asked to assist in managing the financial assets of your plan.

When a change takes place in the benefits package, clear communication is vital to ensure that employees understand the new plan.

Look for a partner that will educate, answer queries, and serve as a continuing resource to your organization for the duration of the partnership.

A partnership doesn’t stop after a plan is in place!

Look for a results-driven partner and the one who reports on your cost savings. A provider should also provide a dedicated support specialist, and that can be a committed resource for a long-term.