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Why are Employers Turning to Reference-Based Pricing to Control Healthcare Costs?

In the last few years, companies have started to turn to reference based pricing as a way to control healthcare costs.  Reference-based pricing is a system where employers can set the maximum amount they intend to pay for a given type of procedure.  The main focus of this technique is procedures that have a wide range of potential prices, but relatively similar results regardless of where the procedure is performed. Why does reference-based pricing matter? In 2015, TrendCT ran an analysis of costs at ... Read more

How Big Pharma is Playing Games with Employers

There are many disliked industries in our country, but few of them are as despised (or as necessary) as pharmaceutical companies. Unfortunately, these companies are playing games with employers like you. Here are two of the main ways they do it. 1) Misrepresenting their costs One of the most common justifications for price-hikes is that "research and development are expensive." That statement, taken by itself, is true. It neatly avoids the fact, however, that they are also spending a lot of money on ... Read more

The War of the Charts

In 2009, Rep. Kevin Brady made the rounds at Fox TV, ABC News and The Drudge Report as a newly minted internet star. The source of the Texas Republican's fame was a stunningly impenetrable graphic created by his staff—65 boxes in six garish colors, interlinked in uncountable ways. The title: “Organizational Chart of the House Democrats' Health Plan.” Within hours, it was available for purchase on a T-shirt with the caption, “Where is MY doctor?” The infographic wasn't exactly explanatory. In fact, ... Read more

Value Based Reimbursement: The Rock Thrown Into The Health Care Pond

By Bruce Merlin Fried and Jeremy David Sherer Value-based reimbursement (VBR), it seems to be everywhere. Launched by the Patient Protection and Affordable Care Act (ACA), a multitude of new payment models and organizations are rapidly reshaping the health care system in ways that are known and, as the ripples of change radiate out from the ACA, in ways that are yet to be understood. For too many years, the traditional fee-for-service (FFS) payment mechanism created incentives to over treat, over prescribe, and over ... Read more