Self-Funded plan designs are becoming more common as medical costs continue to rise. The financial risk has shifted to the employer vs. the carrier under fully-insured plans. In both plan types, participants access medical care through a provider network with established prices for services. MAP® Health offers our services to carriers and third-party administrators.
Reference-Based Pricing ("RBP") is not a traditional medical plan design because it generally does not include a provider network. Instead of contracted rates between the network and provider, it uses a government-based fee schedule. This strategy allows the employer to cap medical procedures that can vary greatly between providers. MAP® Health has a better approach to Reference-Based Pricing.