Why “Good Discounts” Are Costing You a Fortune. Inside a Smarter Healthcare Model: Reference-Based Pricing with Adam Russo, Esq. (Ep. 09)
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Is your PPO network actually saving you money—or just selling you a myth?
In this eye-opening episode of The Benefit Whisperer, host Ralph Weber sits down with Adam Russo, co-founder and CEO of The Phia Group, to expose the broken economics of traditional healthcare pricing. They dive deep into the real story behind Reference-Based Pricing (RBP), why most brokers avoid it, and how smart employers are slashing costs without cutting care.
✅ The truth about PPO “discounts”
✅ Why laziness—not logic—drives plan design
✅ How RBP protects patients from surprise billing
✅ What AI and price transparency mean for the future of healthcare
🎧 Whether you’re a CEO, benefits advisor, or just tired of rising deductibles and shrinking benefits, this episode will change how you think about cost, quality, and control in healthcare.
🔗 Learn more about Adam Russo and The Phia Group: https://phiagroup.com
📩 Contact Ralph: Ralph@thebenefitwhisperer.com
📞 Call: 832-924-3330
Chapters
00:00 Introduction to Healthcare Challenges
02:36 Understanding Reference-Based Pricing
06:40 The Necessity of Reference-Based Pricing
12:47 Consumerism in Healthcare
18:41 Addressing Balance Billing Concerns
22:22 The Power of Representation in Healthcare Billing
24:18 Understanding Healthcare Pricing Variance
26:40 The Importance of Patient Education
28:15 Challenges in Educating Employers and Employees
32:24 Implementing Reference-Based Pricing
34:54 Analyzing Healthcare Data for Cost Reduction
36:33 The Role of AI in Healthcare Transparency
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