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Transparency, cost containment sought in Medicare-based pricing technique

Through reference-based pricing, employers set prices for a self-funded insurance plan using Medicare prices as a benchmarking tool. Employers agree to pay providers a certain percentage on top of the average Medicare rate — usually in the range of 125%-200%. For many employers, this means leaving behind their carrier and networks.

Justin Henry
Justin Henry is the regional reporter for the Central Penn Business Journal and the Lehigh Valley Business. He can be reached at jhenry@bridgetowermedia.com.

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