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Exploring Reference-Based Pricing as a Method for Lowering Healthcare Costs
Reference-based pricing has been touted as a way to contain healthcare costs while ensuring quality of care. We talk with with David Henka, chief executive officer of ActiveRADAR, to dig deeper into how the method is used in practice and what program results have shown.
Reference-based pricing has been touted as a way to contain healthcare costs while ensuring quality of care. When implemented, health plans or employers compare the costs of all brand-name and generic drig options within a certain therapeutic category and identify the lowest cost options. From there, copays are adjusted to encourage the use of the lowest cost alternatives, with plans covering the cost of a drug or service up until the reference point.
With research showing that these programs can reduce costs by an average 20% each year, we sat down with David Henka, chief executive officer of ActiveRADAR, to dig deeper into how the method is used in practice and what program results have shown.
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Inside the Center's MDD Value Model and Its Use of Dynamic Pricing
May 13th 2025Larragem Raines, MS, of the Center for Innovation & Value Research, discusses the organization's major depressive disorder (MDD) open-source value model, dynamic pricing, and the future role of artificial intelligence in care.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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ERISA Industry Committee Sues Minnesota Over PBM Law
January 3rd 2025The Employee Retirement Income Security Act (ERISA) Industry Committee filed a legal challenge against the Minnesota Department of Commerce, arguing that Minnesota’s Pharmacy Benefit Manager (PBM) Licensure and Regulation Act illegally interfered with employer-sponsored health plans by restricting plan design options and increasing costs.
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