Shawn Fried, PMP

Shawn Fried, PMP

Shawn A. Fried, PMP is an experienced Health Insurance Underwriter with almost 30 years experience working in the healthcare delivery and insurance industries. He serves as the Director of Underwriting for the JP Griffin Group in Scottsdale, Arizona. Before joining the JP Griffin Group, Shawn worked as an Underwriter, Project Manager, IT Marketing Management, and Network Contract Management for 20+ years between BlueCross and BlueShield of Arizona, and TriWest Healthcare Alliance. Shawn holds a Bachelor of Science degree in Business, with a focus on IT Management and Marketing, from the University of Phoenix. Shawn is licensed as a Project Management Professional, and Arizona Health and Life Producer/Broker.
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What Is Reference Based Pricing?

Shawn Fried, PMP

In the never-ending quest to decrease employee benefits spending on healthcare, some employers are turning to a somewhat revolutionary concept called reference based pricing. This switch is most common among large employers (500 employees or more) who are self-funded, and is gaining popularity rather quickly. For those who may be interested in implementing such a program, it’s important to understand how it differs from traditional healthcare plans, as well as how it will affect those enrolled in it.

What Is Reference Based Pricing?

Reference based pricing (RBP) is a system that some employers have started to use for cost containment purposes. This method is different from more traditional pricing options in that the employer caps the amount they’ll agree to cover for certain non-emergent medical procedures that can vary greatly in price yet not in outcome, such as hip or knee replacements.

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Topics: Employee Benefits, Cost Containment, Education, employers

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Containing Employee Benefit Costs Through Value-Based Insurance Design (VBID)

Shawn Fried, PMP

As the cost of healthcare continues to rise with seemingly no end in sight, employers of all sizes across the entire country are looking for ways to cut costs without compromising the quality of care. Many employers have already moved toward consumer directed healthcare, but another strategy some employers are turning toward is value-based insurance design (VBID).

While value-based insurance design is far from a topic discussed at the dinner table, it isn’t a new concept. In fact, one state adopted this plan design in 2008 and some principles of VBID, such as low-cost preventative care and wellness visits, were incorporated into Section 2713 of the Affordable Care Act (ACA).

VBID takes a very different approach than HDHPs (high deductible health plans)  when it comes to trying to save employers and employees money, so if you’re thinking of making a change to your employer-sponsored health insurance, it’s important to understand exactly what you’re signing yourself (and your employees) up for.

What Is Value-Based Insurance Design?

Value-based insurance design is a cost containment strategy being adopted and tested by some employers. This plan structure is different from traditional health insurance plans in that its purpose is to decrease costs for medical services deemed as “higher value,” while increasing costs for those considered to be “low value.”

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Topics: Employee Benefits, Cost Containment, Education, Plan Design

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