优选提供者组织的运营及法律影响

Operational and legal implications of preferred provider organizations.

作者信息

Adams-Ryan D, Peddecord K M, Root G L

出版信息

Hosp Health Serv Adm. 1985 May-Jun;30(3):44-57.

Abstract

The healthcare marketplace of the 1980s is competitive. Federal policymakers, private insurers, and businesses have formulated innovative ways to increase price competition within the healthcare sector. The 1980s have been characterized by a shift from a regulatory emphasis to one including both regulation and competition in an effort to contain healthcare costs. This article examines preferred provider organizations (PPOs) and differentiates them from health maintenance organizations (HMOs) and exclusive provider organizations (EPOs). It also reviews alternate PPO models and discusses operational and legal implications.

摘要

20世纪80年代的医疗保健市场竞争激烈。联邦政策制定者、私人保险公司和企业已经制定了创新方法，以增强医疗保健领域内的价格竞争。20世纪80年代的特点是从强调监管转向既包括监管又包括竞争，以控制医疗保健成本。本文研究了优选提供者组织（PPO），并将其与健康维护组织（HMO）和独家提供者组织（EPO）区分开来。它还回顾了替代的PPO模式，并讨论了运营和法律方面的影响。