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Journal Article
J Health Polit Policy Law (1986) 11 (2): 305–322.
Published: 01 April 1986
...Jon Gabel; Dan Ermann; Thomas Rice; Gregory de Lissovoy A new development in the restructuring of American health care is the dramatic growth of preferred provider organizations (PPOs). Based on a national telephone survey, this paper assesses the future direction of PPOs by examining segments...
Journal Article
J Health Polit Policy Law (1989) 14 (2): 367–382.
Published: 01 April 1989
...Thomas Rice; Jon Gabel; Gregory de Lissovoy This paper reports the results of a national survey on employer experiences with preferred provider organizations (PPOs). The survey, conducted in 1987, included information from almost 700 telephone interviews with employee benefit managers. We found...
Journal Article
J Health Polit Policy Law (2016) 41 (4): 743–762.
Published: 01 August 2016
... preferred provider organization (PPO) plans, and the state Medicaid program fell short of its payment reform goals. Provider groups will not fully commit to population-based clinical models if they believe it will result in large reductions in fee-for-service revenue. The use of alternative payment models...
Journal Article
J Health Polit Policy Law (1993) 18 (1): 75–103.
Published: 01 February 1993
... agent) with a designation that broadcast its unique feature. These new monikers included network model plans, preferred provider organizations (PPOs), primary care networks (PCNs), competitive medi- cal plans (CMPs), health insuring organizations (HIOs), triple-option plans (TOPS...
Journal Article
J Health Polit Policy Law (1988) 13 (2): 279–291.
Published: 01 April 1988
... commonplace. HMOs and especially PPOs are booming. Blue Shield and Blue Cross market share and market power are declining. We discuss why the insurance market has changed and conclude with thoughts on the future. Copyright © 1988 by Duke University Press 1988 References de Lissovoy , Gregory...
Journal Article
J Health Polit Policy Law (1993) 18 (1): 105–112.
Published: 01 February 1993
... Printing Office. Woolhandler , S. , and D. Himmelstein. 1991 . The Deteriorating Administrative Efficiency of the U.S. Health Care System. New England Journal of Medicine 324 ( 18 ): 1253 -58. Wouter , A. V. 1990 . The Cost of Acute Outpatient Primary Care in a PPO. Medical Care 28...
Journal Article
J Health Polit Policy Law (1988) 13 (4): 683–704.
Published: 01 August 1988
... systems will provide a standard of medical practice against which medical staff performance can be compared (Hospitals 1987d). If medical and cost outliers can be identified, hospitals may be in a better position to negotiate with physicians, insurers, and other purchasers (e.g., HMOs and PPOs...
Journal Article
J Health Polit Policy Law (2007) 32 (2): 317–347.
Published: 01 April 2007
.../100404_ptc_SH_comment.pdf . Harris, Milton, and Artur Raviv. 1981 . Allocation Mechanisms and the Design of Auctions. Econometrica 49 : 1477 -1499. HealthLeaders-Interstudy. 2005. Humana Announces Plans for Regional Medicare PPOs in Georgia, Alabama, South Carolina, and Tennessee. News release, Decision...
Journal Article
J Health Polit Policy Law (1997) 22 (5): 1133–1189.
Published: 01 October 1997
... health maintenance organization (HMO) enabling statutes were required in many states to authorize HMOs to contract exclusively with limited groups of providers. The 1980s saw the emergence of new types of man- aged care plans, including preferred provider organizations (PPOs). The 1...
Journal Article
J Health Polit Policy Law (2007) 32 (2): 221–246.
Published: 01 April 2007
... . Packet distributed to Republican members of Congress, January 27 . Hurley, Robert E., B. C. Strunk, and J. S. White. 2004 . The Puzzling Popularity of the PPO. Health Affairs 23 ( 2 ): 56 -68. Kaiser Family Foundation. 2006. Tracking Medicare Health and Prescription Drug Plans: Monthly...
Journal Article
J Health Polit Policy Law (1999) 24 (5): 1033–1043.
Published: 01 October 1999
... response to this problem has been to subdivide the man- aged care universe into a collage of competing acronyms: HMOs, pre- ferred provider organizations (PPOs), exclusive provider organizations (EPOs), and the like. This is the approach taken by Jonathan Weiner and Gregory de Lissovoy in their oft...
Journal Article
J Health Polit Policy Law (1994) 19 (2): 423–447.
Published: 01 April 1994
... (PPOs) in order to obtain plan subscribers as patients. In exchange for price dis- counts and other concessions, hospitals that are awarded contracts become part of a plan’s provider network. Payers generally offer financial in- centives (e.g., reduced copayments and deductibles) to steer...
Journal Article
J Health Polit Policy Law (1999) 24 (5): 1045–1049.
Published: 01 October 1999
... alike have been eagerly watching and evaluating the growth of so-called managed care plans. Many expected prepaid group practice plans (PGPs), then individ- ual practice associations (IPAs), then preferred provider organizations (PPOs), and a host of other insurance arrangements under the managed...
Journal Article
J Health Polit Policy Law (2015) 40 (4): 669–688.
Published: 01 August 2015
... are also expanding in response to both the ACA and market trends that emphasize paying for value instead of volume (Lewis et al. 2013 ). These commercial ACOs are layered onto existing HMO and preferred provider organization (PPO) products for specific populations, whereby financial incentives are tied...
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Journal Article
J Health Polit Policy Law (1987) 12 (4): 723–739.
Published: 01 August 1987
... . Hybrid HMOs, PPOs: The New Focus. Business and Health 4 : 20 -27. Gabel , J. , D. Ermann, T. Rice, and G. de Lissovoy. 1986 . The Emergence and Future of PPOs. Journal of Health Politics, Policy and Law 11 : 305 -22. Group Health Association of America, Inc., and American Medical Care...
Journal Article
J Health Polit Policy Law (1992) 17 (1): 3–24.
Published: 01 February 1992
... organizations (PPOs). In areas where there is the most competition among competing medical plans, working-age individuals have been shown to be sensitive to the health insurance premiums that they pay (Schuttinga et al. 1985; Long et al. 1988). But many observers This research was conducted...
Journal Article
J Health Polit Policy Law (2000) 25 (1): 133–173.
Published: 01 February 2000
... typically offer preferred provider (PPO) products in the individual market. In addi- tion, under the terms of the 1993 law, after 1995 insurers would be pro- hibited from selling products—including their pre-reform policies—that were beneath the benefits and cost...
Journal Article
J Health Polit Policy Law (1983) 8 (3): 598–606.
Published: 01 June 1983
... will then compete to develop lower-cost plans and innovative financing and delivery arrangements, such as HMOs, preferred provider organizations (PPOs), and health care alliances. Pri va te-sect0r cost-conta in men t efforts As public policy has evolved in both the regulatory and competitive di...
Journal Article
J Health Polit Policy Law (1990) 15 (3): 656–664.
Published: 01 June 1990
... suggests that these organizations lower costs with- out lowering quality, although continued research is needed to monitor their per- formance” (p. 108). Frech, in Health Cure in America, contrasts preferred provider organizations (PPOs) with HMOs in terms of quality. With PPOs, the cost of going...
Journal Article
J Health Polit Policy Law (1988) 13 (2): 223–225.
Published: 01 April 1988
... of preferred provider organizations (PPOs) and selective contracting plans. One: of the most dramatic changes has occurred in the insurance industry. In 1977, insurers paid the costs of the provider re- gardless of price or quantity of services delivered. Today, utilization review ef- forts, managed...