Free Research Report / 2026
The State of Reference-Based Pricing in U.S. Healthcare Markets
Where RBP is winning, where balance billing risk is highest, and which markets offer the largest cost containment opportunity, analyzed from hospital MRF files and employer data.
50+
Markets analyzed
6,600+
Hospital MRF files
32
Pages
Key Findings
What the data shows.
3.1x
Median hospital rate spread within a single market.
23%
Median potential savings for self-insured employers in mid-sized markets.
14
Markets with favorable RBP acceptance environments.
6x
Difference in balance billing risk score across major markets.
Report Contents
What's inside the full report.
Market-specific data, methodology notes, and actionable guidance for consultants, TPAs, and employers evaluating RBP strategy.
01
The RBP Opportunity Landscape
Current state of RBP adoption by market, employer size, and industry.
02
Market-by-Market Rate Spread Analysis
Hospital rate variance within 50+ MSAs, ranked by spread magnitude.
03
Balance Billing Risk Index
Market-level risk based on rate positioning, volatility, and payer mix context.
04
Savings Opportunity by Service Category
Orthopedics, imaging, outpatient surgery, cardiac, and other common categories.
05
Quality-Cost Landscape for RBP Steerage
Markets with facilities below market cost and above quality floor thresholds.
06
Implementation Readiness Checklist
Plan design, member communication, partner selection, and quality floor criteria.
Who It's For
Built for the practitioners making RBP decisions.
Consultants & Brokers
Win with market-specific data
Show employers their savings range and facility risk before the proposal.
TPAs
Defend repricing decisions
Understand market positioning before setting RBP thresholds.
Employers
Evaluate before committing
Assess savings potential and balance billing risk by geography.
Health Systems
Understand the RBP environment
Track adoption and rate position with market context.
Next Step
Ready to See Your Market's Data?
The report gives you the market overview. The platform gives you the drilldown by facility, category, and provider.