Preferred provider organizations: today's models and tomorrow's prospects.
Preferred provider organizations (PPOs) have recently attracted much attention as an alternative to both traditional fee-for-service medicine and health maintenance organizations. To examine their development and structure, we conducted a telephone survey with executives of more than 130 operational PPOs. We describe typical examples of the three most common types of PPOs-those sponsored by providers, insurers, and entrepreneurs-and identify problems each faces in the increasingly competitive health care environment. We then cite approaches that innovative PPOs are using to deal expressly with these problems.
D054598:Blue Cross Blue Shield Insurance Plans / Q000458:organization & administration; D003669:Deductibles and Coinsurance; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007342:Insurance Benefits; D007345:Insurance Claim Review; D007348:Insurance, Health / Q000458:organization & administration*; D008389:Marketing of Health Services; D011243:Preferred Provider Organizations / Q000458:organization & administration*; D012051:Reimbursement Mechanisms; D014481:United States