Gretchen Harders, a Member of the Firm in the Employee Benefits practice, in the firm’s New York office, was quoted in Benefit News, in “Do TPAs Help Self-Insured Employers?” by Amanda Eisenberg.
Following is an excerpt:
Therein lies a challenge for self-funded employers: They don’t actually know how much health services really cost, despite having access to price transparency lists, says Gretchen Harders, a member with law firm Epstein Becker & Green.
“Those kinds of prices that the providers publish don’t often include the real price,” she says, noting it doesn’t include rebates or discounts that the TPA might have negotiated. “You don’t actually see the real price, and that’s the big criticism.” …
Usually, Harders says, employers have little negotiating power when they use a TPA that doesn’t necessarily have a specific employer’s interest at heart.
Although some employers have the resources to break away from a TPA and negotiate service agreements directly, most are only able to negotiate with one or two providers, says Harders.