Reference-Based Pricing Survey

Reference-Based Pricing Survey

Amarillo, TX – The OccuNet Company’s recent survey of employers demonstrated an increased interest in adopting reference-based pricing (“RBP”) plan options in exchange for better healthcare affordability. Regardless of employer group size, approximately nine out of ten employers indicated that they would be interested in realizing a 25-30% reduction in healthcare expenses and potential "balance bills" on less than 5% of claims to patients for the difference between the total cost of services charged and the amount remitted (Figure 1). These findings come from The OccuNet Company’s Reference-based Pricing Survey, 2022. The OccuNet Company conducted the survey in July 2022 across 217 employers with 100-5,000+ U.S.-based employees with employer-sponsored private health insurance.

Employers have traditionally looked to less disruptive and long-established medical cost containment solutions such as wellness programs, additional health plan options (e.g. high deductible health plans), pharmacy benefit changes, and plan design changes to combat cost pressures. However, innovative solutions such as narrow networks, RBP, and level funding, are perceived by employers to be more effective in managing employee medical costs despite their less widespread adoption. As such, employers may have increased appetites for innovative solutions during the benefits procurement process, given the uncertainty within the current economic environment.

Increasing interest in RBP plan options may be due to most employers expecting healthcare expenses to grow continuously over the next three years while leading RBP plan providers such as The OccuNet Company consistently deliver 30%+ in savings with balance bills on 1% of claims. For example, most respondents (61%) say they expect costs to increase by at least 6-10% over the next three years, with nearly half (42%) of these respondents expecting costs to increase by at least 11-15% due to ongoing inflation and potential recession risks.

“Affordable and transparent healthcare models are integral to supporting employees in their increasingly uncertain healthcare journeys given recent economic instability. The OccuNet Company is grounded in a mission to provide members with exceptional experiences and comprehensive access to affordable and high-quality health care” said Caleb Fairly, President of The OccuNet Company.

“Reference-based pricing is one of the fastest growing cost containment solutions that employers are adopting today. Rising cost pressures and fears of recession and inflation have added to the momentum of employers searching for customizable benefits offerings that include innovative cost containment solutions” said Evan Portnoy, Owner of Rampart Benefit Planning.

“HealthComp has been dedicated to transforming benefits administration by bringing expert medical cost management solutions that integrate seamlessly with any benefits ecosystem. Reference-based pricing is a leading solution that is both flexible and data-driven in supporting the shifting needs of employers” said Tom Martel, Chief Growth Officer of HealthComp

To receive a complimentary Executive Summary of The OccuNet Company’s Reference-based Pricing Survey, 2022 please click here.

About The OccuNet Company’s Reference-based Pricing Survey, 2022

To understand employers’ perceptions of both healthcare expense trends and medical cost containment solutions, The OccuNet Company collaborated with Dynata – the world’s largest first-party data platform for insights, activation, and measurement. The study surveyed 217 employers with 100-5,000+ U.S.-based employees with employer-sponsored private health insurance on July 8-15, 2022. Surveys were self-administered through an online survey.

About The OccuNet Company

The OccuNet Company is an innovative healthcare cost containment company that offers out-of-network solutions (OccuNet), reference-based pricing (Fairos), and pharmacy benefits management (FairosRx). Our industry-unique set of cost-containment offerings makes healthcare more intelligent, streamlined, and cost-effective while improving the health and well-being of those we serve. For more information, visit or follow us @TheOccuNetCompany on LinkedIn or Facebook. For sales & media inquiries please contact