Reference Based Pricing: What and Why?
Do you want to be on the leading edge of Healthcare?
The key is Cost-Containment Strategies
How Reference Based Pricing (RBP) can be the next solution for Employer Based Health Plans. 
With rising cost of healthcare plans, employer groups are looking at new health tactics that provide cost-shifting to their employees.

A successful RBP program requires a comprehensive approach that employers set pricing limits on the maximum amounts they will cover on particular heath care service. The employee can choose the providers at the reference price and pay the difference between the actual price of the service and the employer's limit. Or go with a provider that will reduce their price to the reference price.

BMA has partnered with leading vendors in technology and reimbursement experience in the healthcare industry.  With over 100 years of aggregate reimbursement experience we have assembled a team of experts to help manage the reference-pricing program from the plan inception to claim resolution. 

Together, BMA can offer a proactive RBP plan that is simple, straightforward and saves money!!! 

We provide:

consulting on plan design

member education

patient advocacy

medical management

comprehensive reference pricing

apparel management

provision of member and provider liaisons

balance-bill negotiation


To learn more about how we can help you, contact us!

(Be sure to check out the article below about how the state of Montana is implementing Reference Based Pricing.)
Montana Negotiates Price Transparency in Hopes of Controlling Rising Medical Costs
By: Jackie Yamanaka, Montana Public Radio

Governor Steve Bullock projects Montana taxpayers could save about $25 million dollars because of the way it manages medical costs for its state employees.

Under the old system, providers could charge the state of Montana's health plan different amounts for the same service. Under a new transparent pricing model Allegiance, the state's third party administrator, is contracting with facilities. Allegiance is using Medicare as a national point of reference for costs. It then pays hospitals a multiple above that. 

Secrets to Making Reference-Based Pricing Work
By: Adam Russo, HR Daily Advisor            

In order for reference-based pricing to work, health plan sponsors should do it in a way that involves implementing best practices for cost analysis, claim repricing, plan design, patient advocacy (including balance billing protection when necessary), and member education.

In Case You Didn't Know
Our Web Portal is Key 

At BMA, we work with you to come up with the best solution for the management of self-funded benefit plans. We provide brokers with comprehensive medical, dental, vision, and prescription drug options by utilizing our secure, online web portal. 

The web portal provides:   
  • Online Documents
  • Telemedicine
  • Monthly Wellness Newsletter 
  • Health Advocate Program
  • Networks
  • Secure Email
  • Performance Reports: Census data, Utilization, and Much More.
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