Association of a national insurer's reference-based pricing program and choice of imaging facility, spending, and utilization.

ABSTRACT:

Objective

To examine the association of a national insurer's reference-based pricing (RBP), program for outpatient advanced imaging-a benefit design to encourage patients to choose lower-price facilities.

Data source/study setting

Administrative and medical claims data for three self-insured employers that introduced RBP and a comparison group without RBP.

Study design

Difference-in-difference comparison of pre-RBP (2014) and post-RBP (2015-6) care between intervention and comparison groups.

Data collection/extraction method

We identified 137 680 imaging procedures (4602 intervention group; 133 078 comparison group) in 2014-2016.

Principal findings

In the first post-RBP year (2015), there was no change in choice of facility; by the second year, RBP-expos

SUBMITTER: Sinaiko AD 

PROVIDER: S-EPMC7240778 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature