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Montana may be stepping back from reference-based pricing model

Posted On: Oct. 31, 2022 9:26 AM CST

Montana is signaling it might step away from an innovative way of setting the prices its public employee health plan pays hospitals for services, an approach that has saved the state millions of dollars and become a model for health plans nationwide, reports the Montana Free Press. The plan gained national renown among employers and health care price reform advocates when, in 2016, it established maximum amounts the health plan would pay for all inpatient and outpatient services, the report says. Those amounts were pegged to Medicare reimbursement rates.