Should you be considering an alternative health plan this year?
As healthcare costs continue to climb—with 2025 projections noting an 8% increase, the highest in over a decade—employers and their brokers are urgently rethinking traditional plan models. The growing interest in alternative health plans isn’t just a trend; it’s a necessary response to unsustainable costs and outdated coverage models.
But what exactly is a modern-day alternative health plan?
These plans, such as those using reference-based pricing (RBP), challenge the traditional preferred provider organization (PPO) approach by basing payments on transparent benchmarks like Medicare rates or hospital cost-to-charge ratios instead of inflated, arbitrary charges. The result: more predictable costs, fewer billing surprises, and greater plan design flexibility. Still, misconceptions around risk, complexity, and provider access often cloud the conversation. We unpack many of the myths surrounding alternative health plan designs in this Fact vs. Fiction blog.
One approach gaining momentum is Claritev’s VistaraTM, an alternative plan design that leverages reference-based pricing to reset the rules around affordability, transparency, and employee empowerment.
But with innovation comes curiosity—and questions.
That’s why we compiled an exclusive Q&A guide based on real broker and employer questions, providing clear, honest answers about how Vistara actually work, who they’re for, and what results they drive.
Ready for real clarity on Vistara? Download the full guide: “Alternative Health Plan Questions Answered
Here’s a quick preview:
Common questions we hear from employers and brokers
QUESTION
Can employers offer a Vistara alongside a preferred provider organization?
ANSWER
Yes, and it’s often a smart strategy. Offering both can increase employee engagement, highlight the value of Vistara, and allow employers to transition gradually based on data and employee feedback.
QUESTION
Is Vistara only for large companies?
ANSWER
Not at all. These plans are scalable and customizable, making them a strong option for companies of all sizes, from small teams to large enterprises.
QUESTION
Will my employees be able to keep their current doctors?
ANSWER
In most cases, yes. For example, Claritev’s Vistara boast a 98% provider acceptance rate, thanks to hybrid plan structures that pair reference-based pricing for facilities with traditional networks for physicians.
These are just a few of the topics we unpacked in the full guide.
Other questions answered in the eBook:
- How does reference-based pricing actually work?
- What’s the real difference between a preferred provider organization and an alternative plan?
- What should employers know about employee adoption and satisfaction?
- What kind of provider networks and acceptance rates can you expect?
- How does Vistara address balance, or surprise, billing?
- How do you educate employees for a smooth rollout?
- How do you choose the right TPA to guide the process?
- How long does it take for employers to see results?
Curious about the answers? Download the full guide
Still holding on to some misconceptions?
You’re not alone. Many brokers and employers still assume:
- “These plans are too risky.”
- “My employees won’t understand them.”
- “They only work in certain industries.”
We tackle these myths head-on in this companion blog:
Separating Fact From Fiction: The Truth About Alternative Health Plan Designs
Real-world results, real savings
One Vistara client in the K–12 sector saved $25M+ in one year with Vistara—and doubled those savings by year three. Claritev’s Vistara isn’t a theory; it’s a tested solution already making a difference. Read more about their story in the guide.
It’s time to stop asking whether you can consider an alternative. The real question is: Can you afford not to?
