Reference-based pricing helps control lab costs

When consumers know costs, they choose less expensive option, Cigna study finds

Reference-based pricing can help control lab costs when consumers are supported with education and an online shopping tool, according to a new study from Cigna and Safeway that was published in the American Journal of Managed Care.

To analyze whether reference-based pricing would impact the choices consumers make for lab services, Cigna and Safeway set the reference price, which is the maximum amount the health plan will pay for a particular service; participating employees choosing services above the reference price were responsible for the additional cost.

The study separated two groups of consumers enrolled in a Cigna plan. The first group was Safeway employees with a reference-based pricing benefit for lab services, such as a lipid panel, metabolic panel or prostate-specific antigen test. The second group was made up of employees from different companies who didn't have the benefit but received the same lab services.

The first group also had access to an online shopping tool that provided information about lab services' cost, location and type, as well as educational information about the benefit.

"Ultimately, it's up to individuals to make choices that are right for them, but the education and online tools that health plans and employers offer can help individuals make more informed decisions," Jackie Aube, Cigna's vice president for product, said in a statement.

In fact, the study found that consumers in the first group, who had the reference-based pricing benefit, were 20 percent more likely to choose lab services below the reference price compared to the consumers in the second group.

Despite the success found in this analysis, a report from the National Institute for Health Care Reform found that reference pricing doesn't actually decrease healthcare spending, FierceHealthPayer previously reported.

To learn more:
- read the Cigna statement and study

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