Kelly M P
Jennings Ryan & Kolb, Jacksonville, FL, USA.
Healthc Financ Manage. 1997 Jul;51(7):44-6.
Provider-sponsored organizations (PSOs) are health risk-bearing entities that assume risk either by contracting directly with individuals, employers, or other groups, or by entering into risk agreements with HMOs. Under the former arrangement, the PSO is generally subject to state insurance licensure requirements. Under the latter arrangement, the PSO is generally not directly regulated. The National Association of Insurance Commissioners (NAIC) has recommended that direct-contracting PSOs be subjected to the same requirements as HMOs, including minimum cash reserves. Arguments have been made that requiring such reserves of PSOs is burdensome and inappropriate. The NAIC has begun a Consolidated Licensure for Entities Assuming Risk (CLEAR) initiative to establish means by which states may regulate all organizations that perform managed care functions and assume health insurance risk.
提供者赞助组织（PSO）是承担健康风险的实体，它们通过直接与个人、雇主或其他团体签约，或与健康维护组织（HMO）签订风险协议来承担风险。在前一种安排下，PSO通常要遵守州保险许可要求。在后一种安排下，PSO通常不受直接监管。美国全国保险专员协会（NAIC）建议，直接签约的PSO应与HMO遵守相同的要求，包括最低现金储备。有人认为，要求PSO具备此类储备既繁琐又不合适。NAIC已启动一项承担风险实体综合许可（CLEAR）倡议，以建立各州对所有履行管理式医疗职能并承担健康保险风险的组织进行监管的方式。
