Reference-Based Pricing for Employee Healthcare Needs

Organizations that support individuals with intellectual and developmental disabilities operate in a system where government agencies largely set reimbursement rates. Because providers cannot adjust pricing, they often lack the flexibility to raise wages enough to meet staffing demand, resulting in persistent workforce shortages.

With meaningful increases in public funding unlikely, these organizations must find sustainable ways to reduce operating costs while maintaining the quality of care. One effective strategy is Reference-Based Pricing (RBP) for employee health plans, which can lower healthcare expenses and help preserve resources for staffing and services. Providers within the intellectual and developmental disability community have successfully adopted this approach.

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