Reference Based Pricing Research - Results With Prescription Drugs and Procedures

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Reference Based Pricing Research - Results With Prescription Drugs and Procedures 
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Reference Pricing is an insurance benefit design that encourages enrollees to favor providers charging low prices for non-emergency “shoppable” surgical procedures, diagnostic tests, and pharmaceuticals. Reference pricing can motivate providers to compete based on price as well as quality, and to pursue cost-reducing innovations.

The Berkeley Center for Health Technology (BCHT) conducted a series of studies on the impact of reference pricing on consumer choice, provider prices, and savings for surgical procedures (orthopedics, ophthalmology), diagnostic procedures (CT scans, MRI scans, colonoscopies), laboratory tests, and prescription drugs, using health insurance data from insurers, self-insured employers, and employer associations.

BCHT studied the impact of reference pricing on orthopedic and ophthalmologic surgical procedures; diagnostic procedures including CT scans, MRI scans, and colonoscopies; laboratory tests; and prescription drugs. Data for these health insurance studies were obtained from large self-insured employers and employer associations: the California Public Employees Retirement System (CalPERS), Safeway, and the RETA Trust. Each study compared the choices made by the insured groups before and after introducing reference pricing, to the choices made by comparable employed groups not subject to reference pricing. Comparison group data were obtained from health insurance provider Anthem, Inc. and pharmacy benefit manager Envision Rx.

Reference pricing was shown to channel consumer choice toward lower-priced providers and products, and to significantly reduce spending. No effect was observed in utilization rates or in surgical complications. The implementation of reference pricing was associated with increases in consumer cost sharing for some services and products, and in decreases for others.

Please join us Thursday, October 5th, 2017 at 1 PM Eastern as UC Berkeley's James Robinson, PhD, MPH and CalPERS' Kathleen Donneson, DPA, CPHIT, CPEHR discuss their research, purchaser experiences and consumer implications in the HealthcareWebSummit event: Reference Based Pricing Research - Experience With Prescription Drugs and Procedures.
Learning Objectives

After attending this webinar, attendees will be able to:

  1. Understand the framework and application of reference based pricing as an insurance benefit design.
  2. Examine BCHT reference based pricing research involving prescription drug and surgical procedures.
  3. Consider purchaser perspectives and experience in offering reference based pricing in their employee benefit design.
  4. Explore implications for consumers in treatment selection and out of pocket spending.
  5. Engage in interactive learning through online question submission, attendee feedback and opportunity for follow up questions, and networking with attendees, faculty and other professionals through dedicated LinkedIn group.
Who Should Attend

Interested attendees would include:

  • C-Suite Executives
  • Value Based Payment Executives and Staff
  • Provider Contracting Executives and Staff
  • Analytics Executives and Staff
  • Actuarial Executives and Staff
  • Finance Executives and Staff
  • Managed Care Executives and Staff
  • Planning and Strategic Executives and Staff
  • Business Intelligence Staff
  • Finance Executives
  • Other Interested Parties

Attendees would represent organizations including:

  • Health Plans
  • Employers
  • Third Party Administrators
  • Life Science Organizations
  • Pharmaceutical Benefit Managers
  • Hospitals and Health Systems
  • Provider Networks
  • Medical Groups
  • Other Providers
  • Government
  • Solutions Providers
  • Associations, Institutes and Research Organizations
  • Media
  • Other Interested Organizations
Reference Based Pricing Research - Results With Prescription Drugs and Procedures
  Individual Registration Fee: $195. Post-event materials, with video of slides synchronized with speaker audio, plus presentation pdf file: $45 for attendees; $260 for non-attendees after the event. Register online or download the event flyer.
Register Now   Corporate Site licensing also available. Click here to register or call 209.577.4888 We look forward to your participation in this event!
James C. Robinson PhD

James C. Robinson,
Leonard D. Schaeffer Endowed Chair in Health Economics and Policy
Director, Berkeley Center for Health Technology
Division Head, Health Policy & Management
UC Berkeley School of Public Health

  James Robinson is Leonard D. Schaeffer Professor of Health Economics and Director of the Berkeley Center for Health Technology (BCHT) at the University of California, Berkeley. He serves on a variety of professional boards and advisory boards, including the Integrated Healthcare Association and National Institute for Health Care Management, and serves as contributing editor for Health Affairs journal. Professor Robinson gives numerous keynote speeches and board presentations for medical technology firms, health plans, hospital systems, medical groups, universities, and public agencies.
At Berkeley, Professor Robinson’s research focuses on the biotechnology, medical device, insurance, and health care delivery sectors. He has published three books and over 130 papers in peer-reviewed journals such as the New England Journal of Medicine, JAMA, and Health Affairs. His most recent book, “Purchasing Medical Innovation: The Right Technology for the Right Patient at the Right Price” analyzes the roles of the FDA, health insurers, hospitals, and consumers in the assessment, purchasing, and use of high-cost implantable devices.
Professor Robinson’s econometric research currently centers on the impact of reference pricing on consumer choices, employer spending, and health outcomes for inpatient and outpatient surgery, laboratory tests, diagnostic imaging, and pharmaceuticals.

Kathleen Donneson, DPA

Kathleen Donneson,
Chief, Health Plan Administration Division
Benefit Programs Policy and Planning
California Public Employees Retirement System


Kathleen Donneson has served as Chief, Health Plan Administration Division for CalPERS since 2010. As Chief, she oversees health plan contracts, association plan offerings, and the Long Term Care (LTC) program. Her duties include managing health and long term care operations and procurements, health and long term care funding, member grievances and appeals, capitation and fee for service premium distribution, clinical programs and benefits, carrier financial reporting and provider network performance.

Kathleen manages teams who evaluate alternative benefit and clinical designs, implement ACA provisions, analyze health information technology requirements and other e-commerce initiatives, and conduct business planning, operations and oversight for programs that serve 1.4 million members and over $8.0 billion in health benefits and $3 billion in LTC benefits. She coordinates health program reporting requirements with CalPERS Information Technology, Legal, Audit, Risk Governmental Affairs and Actuarial Services; and aligns Division strategic planning goals and policies to enterprise strategies.

Previously, Kathleen served as Assistant Division Chief and Manager, Health Services Research for CalPERS from 2002 to 2010. She served as adjunct Faculty for Univ. of Southern California, Univ. of Maryland, European Division, USF, and CSU Hayward during 1995 to 2002. Kathleen has a Doctorate in Public Administration from the University of Southern California, a Master's degree in Health Administration from the University of San Francisco, and a Bachelor of Science from University of California, Davis.

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