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If reference-based benefit designs work, why are they not widely adopted? Insurers and administrators not doing enough to address price variation.如果基于参考的福利设计行之有效，为何未被广泛采用？保险公司和管理人员在应对价格差异方面做得不够。
Health Serv Res. 2020 Jun;55(3):344-347. doi: 10.1111/1475-6773.13284. Epub 2020 Mar 29.
2
Costs, commitment and locality: a comparison of for-profit and not-for-profit health plans.成本、承诺与地区性：营利性与非营利性健康保险计划的比较
Inquiry. 2004 Summer;41(2):116-29. doi: 10.5034/inquiryjrnl_41.2.116.
3
[Health insurance: no transparency concerning salaries].[健康保险：薪资缺乏透明度]
Rev Med Suisse. 2014 Nov 26;10(452):2295.
4
Zinc presents management "thought starters" for working toward health cost containment.锌为致力于控制医疗成本的管理工作提供了“思考起点”。
Employee Benefit Plan Rev. 1977 Mar;31(9):10-1.
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Pricing behaviour of nonprofit insurers in a weakly competitive social health insurance market.非营利保险公司在弱竞争社会医疗保险市场中的定价行为。
J Health Econ. 2011 Mar;30(2):439-49. doi: 10.1016/j.jhealeco.2010.12.006. Epub 2011 Jan 13.
6
Many health companies try to contain costs, says study.研究称，许多健康公司试图控制成本。
Employee Benefit Plan Rev. 1977 Sep;32(3):75.
7
Insurers' trade group offers its own numbers to fend off administrative cost charges.保险公司行业组织提供了自己的数据以抵御行政成本指控。
Mod Healthc. 1992 May 4;22(18):20.
8
Insurers should stick to insurance.保险公司应专注于保险业务。
J Med Assoc Ga. 2016;105(1):3.
9
The U.S. health insurance industry: an alternative view.美国医疗保险行业：另一种观点。
Int J Health Serv. 1978;8(3):491-507. doi: 10.2190/75KA-EK33-FX0F-0TY0.
10
Public versus private administration of health insurance: a study in relative economic efficiency.医疗保险的公共管理与私人管理：相对经济效率研究
Inquiry. 1978 Dec;15(4):379-87.

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A Policy and Regulatory Framework to Promote Care Delivery Redesign and Production Efficiency in Health Care Markets.促进医疗保健市场护理服务重新设计与生产效率的政策和监管框架。
Milbank Q. 2025 Jun;103(2):316-348. doi: 10.1111/1468-0009.70016. Epub 2025 May 6.
2
Paying patients to use lower-priced providers.付费让患者选择价格较低的医疗机构。
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An Employer-Provider Direct Payment Program Is Associated With Lower Episode Costs.雇主-供应商直接支付计划与较低的医疗费用有关。
Health Aff (Millwood). 2021 Mar;40(3):445-452. doi: 10.1377/hlthaff.2020.01488.

本文引用的文献

1
Association of a national insurer's reference-based pricing program and choice of imaging facility, spending, and utilization.国家保险公司的参考定价计划与影像设施选择、支出和利用之间的关联。
Health Serv Res. 2020 Jun;55(3):348-356. doi: 10.1111/1475-6773.13279. Epub 2020 Mar 10.
2
Price Transparency in Health Care Has Been Disappointing, but It Doesn't Have to Be.医疗保健领域的价格透明度一直令人失望，但并非必然如此。
JAMA. 2019 Oct 1;322(13):1243-1244. doi: 10.1001/jama.2019.14603.
3
Paying Patients To Switch: Impact Of A Rewards Program On Choice Of Providers, Prices, And Utilization.付费患者转换：奖励计划对提供者选择、价格和使用的影响。
Health Aff (Millwood). 2019 Mar;38(3):440-447. doi: 10.1377/hlthaff.2018.05068.
4
Why aren't more employers implementing reference-based pricing benefit design?为什么没有更多的雇主实施基于参照的定价福利设计？
Am J Manag Care. 2019 Feb;25(2):85-88.
5
Comparing The Effects Of Reference Pricing And Centers-Of-Excellence Approaches To Value-Based Benefit Design.比较参考定价和卓越中心方法对基于价值的福利设计的影响。
Health Aff (Millwood). 2017 Dec;36(12):2094-2101. doi: 10.1377/hlthaff.2017.0563.
6
Tiered co-payments, pricing, and demand in reference price markets for pharmaceuticals.药品参考价格市场中的分层共付额、定价和需求。
J Health Econ. 2017 Dec;56:19-29. doi: 10.1016/j.jhealeco.2017.08.008. Epub 2017 Sep 15.
7
Association of Reference Pricing with Drug Selection and Spending.参考定价与药品选择及支出的关联
N Engl J Med. 2017 Aug 17;377(7):658-665. doi: 10.1056/NEJMsa1700087.
8
Reference Pricing Changes The 'Choice Architecture' Of Health Care For Consumers.参考定价改变了消费者医疗保健的“选择架构”。
Health Aff (Millwood). 2017 Mar 1;36(3):524-530. doi: 10.1377/hlthaff.2016.1256.
9
Reference Pricing, Consumer Cost-Sharing, and Insurer Spending for Advanced Imaging Tests.先进成像检查的参考定价、消费者成本分摊与保险公司支出
Med Care. 2016 Dec;54(12):1050-1055. doi: 10.1097/MLR.0000000000000605.
10
Association of Reference Pricing for Diagnostic Laboratory Testing With Changes in Patient Choices, Prices, and Total Spending for Diagnostic Tests.诊断实验室检测参考定价与诊断检测患者选择、价格和总支出变化的关联。
JAMA Intern Med. 2016 Sep 1;176(9):1353-9. doi: 10.1001/jamainternmed.2016.2492.

If reference-based benefit designs work, why are they not widely adopted? Insurers and administrators not doing enough to address price variation.

作者信息

Scanlon Dennis P

机构信息

The Pennsylvania State University, University Park, Pennsylvania.

出版信息

Health Serv Res. 2020 Jun;55(3):344-347. doi: 10.1111/1475-6773.13284. Epub 2020 Mar 29.

DOI:10.1111/1475-6773.13284
PMID:32227337
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7240765/
Abstract
摘要