The development of preferred provider organizations and its antitrust implications.
The preferred provider organization (PPO) is rapidly evolving as a major innovation in the health care industry. Its development has had serious legal antitrust implications. Health care is rapidly becoming more businesslike. Third party payers as well as providers are aggressively pursuing market shares. This has led to combinations and price negotiations that have often confronted the antitrust laws. The PPO is a most prominent example. This article is addressed to a wide range of health professionals. Initially, those antitrust laws applicable to the health care industry are presented. A discussion of the development and structure of PPOs follows. Special attention is directed toward the applicability of the antitrust laws to various forms of PPOs. Although each case must be decided upon its merits, guidelines are suggested to avoid the pitfalls of antitrust prosecution and litigation.
D004465:Economic Competition / Q000331:legislation & jurisprudence*; D004467:Economics / Q000331:legislation & jurisprudence*; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D011243:Preferred Provider Organizations / Q000331:legislation & jurisprudence*; D014481:United States; D014485:United States Federal Trade Commission