Reference-Based Benefit Design Changes Consumers’ Choices And Employers’ Payments For Ambulatory Surgery

• Published in: Health Affairs Vol. 34; no. 3; pp. 415 - 422
• Main Authors: Robinson, James C., Brown, Timothy, Whaley, Christopher
• Format: Journal Article
• Language: English
• Published: United States The People to People Health Foundation, Inc., Project HOPE 01.03.2015
• Subjects: Aged; Ambulatory care; Ambulatory Surgical Procedures - economics; Ambulatory Surgical Procedures - methods; Bone surgery; California; Cataract Extraction - economics; Cataract Extraction - methods; Cataracts; Consumers; Cost Sharing - economics; Cost Sharing - methods; Cost-Benefit Analysis - economics; Cost-Benefit Analysis - methods; Databases, Factual; Departments; Employees; Employers; Eye surgery; Female; Health Benefit Plans, Employee - economics; Health care policy; Health Care Reform; Health Expenditures; Health insurance; Health Personnel - economics; Health Personnel - trends; Hospitals; Humans; Initiatives; Insurance coverage; Male; Middle Aged; Orthopedics; Patients; Policy Making; Prices; Pricing policies; Reference Values; Retrospective Studies; Studies; Surgery; United States > US; Managed Care—Consumers < Managed Care; Consumer Issues; Business Of Health; Health Spending; Managed Competition

Some employers are using reference-based benefit (RBB) designs, also known as "reference-based pricing," to encourage patients to select lower-price ambulatory surgery centers instead of expensive hospital outpatient departments. This article analyzes the impact of such benefit designs for...