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Reference-Based Pricing in Health Insurance: Terminology & Theory [VIDEO]

This is the first segment in a three-part series about reference-based pricing. The first segment introduces the terminology and theory associated with health plans implementing a reference-based pricing model. Additionally, it discusses variations on reference-based pricing models implemented by various types of commercial insurance networks.

Triage: Rapid Legal Lessons for Busy Health Care Professionals has been developed to convey information about developments in health law through short, three to five minute webinars.

If you work in the health care industry, you have grown accustomed to frequent changes in laws and regulations. On some days, it may seem like an insurmountable task to keep up with every change, especially as a new presidential administration and new policies take shape.

Part 2 - Reference-Based Pricing: Case Study & Discussion [VIDEO]

Copyright 2019 K & L Gates


About this Author

Gary Qualls, KL Gates Law Firm, Healthcare Attorney

Mr. Qualls focuses his practice on representing health care clients. He litigates, arbitrates, and mediates healthcare disputes, including disputes involving the following issues: certificate of need; licensing and certification; payment and reimbursement; HIPAA; contracts of all types; medical staff privileges; EMTALA; and civil monetary penalties. He provides a broad range of legal services to the following types of providers: hospital systems; nursing facilities; adult care facilities; continuing care retirement facilities; home health and hospice agencies; dialysis...