Welcome to Ask an Adviser, EBN’s weekly column in which benefit brokers and advisers answer (anonymous) queries sent in by our readers. Looking for some expert advice? Please submit questions to askanadviser@arizent.com. This week, we asked Arthur Chapman, a principal with Reliant Health Partners, to weigh in on the following: What is the difference between reference-based pricing and fair market pricing?
Since employee health benefits typically are in the top five of profit-and-loss expenses, the quest to lower this cost is intense. So-called usual, customary and reasonable pricing charged for services by providers in their particular area rise as they see the need to increase prices, adding to inflationary pressures.
