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Consumer Reports is an independent nonprofit organization that works for a fair, safe and transparent marketplace.

Since we were founded as Consumers Union in 1936, we have advocated for the rights of all consumers. Now, we are united under the Consumer Reports name, bringing together our trusted testing, research, journalism, and advocacy.

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Creating a consumer friendly reference pricing program

Reference pricing is a strategy in which insurers and/or other purchasers set a cap – or “reference price” – to limit the amount they will pay for a certain procedure. When combined with quality thresholds, this strategy is a way to guide consumers toward choosing more reasonably priced providers and to encourage providers to meet set pricing.  This paper provides a set of consumer protection principles intended to ensure that insurers and others maintain consumers’ access to affordable, quality care and an adequate network of providers when implementing a reference pricing program.