| Preferred
Provider Organizations are another attempt to reduce medical costs.
This is an arrangement whereby a selected
group of independent hospitals and medical practitioners in a certain
area agree to provide certain services at a prearranged rate.
The
organizers and providers agree upon medical service charges that are
generally less than the provider would charge patients not associated
with the PPO.
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individual and family, small group, short-term, student, Medicare
supplemental and dental plans.
These
differ from HMOs in that the providers are paid on a fee for service
basis rather than receiving a flat monthly amount and the organizer or
contracting agency might be:
-
Traditional
insurance companies
-
Blue
Cross/Blue Shield
-
Local
groups of hospitals
-
Local
groups of physicians
-
An
existing HMO
-
Large
employers
-
Trade
unions
Those
people who will receive services select a preferred provider from a
list that the PPO distributes.
Usually the choices are more extensive with a
PPO than a HMO.
Sometimes
PPOs and HMOs are lumped together and called a managed care system.
One characteristic still exists concerning
regulation, however.
HMOs increasingly have to meet state
requirements as well as standard established by federal government.
PPOs are less stringently regulated since any
group that can agree on the arrangements can call itself a PPO.
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