Medigap preferred provider organizations: issues, implications, and early experience.
The Health Care Financing Administration is sponsoring the Medicare Physician Preferred Provider Organization (PPO) Demonstration to assess the feasibility and desirability of including a PPO option under Medicare. Two sites are currently operational. At one site, Blue Cross and Blue Shield of Arizona is offering a PPO linked with a medigap insurance plan. This "medigap PPO" and its initial experience are described, and a preliminary assessment of the viability and effectiveness of medigap PPOs nationally is provided. Impediments to the development and effectiveness of medigap PPOs are identified and possible government actions discussed.
Nelson
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Mathematica Policy Research, Inc., Washington, DC 20024.
Swearingen
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Sing
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M
Quinn
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E
D000368:Aged; D001130:Arizona; D054598:Blue Cross Blue Shield Insurance Plans; D003256:Community Participation / Q000191:economics*; D005069:Evaluation Studies as Topic; D006801:Humans; D007342:Insurance Benefits; D006278:Medicare / Q000458:organization & administration*; D009042:Motivation; D010865:Pilot Projects; D011243:Preferred Provider Organizations / Q000458:organization & administration*; D012959:Socioeconomic Factors; D014481:United States