A preferred provider organization (PPO) is a combination of a traditional fee-for-service plan
and an HMO.
A provider, health professional, or other entity is treated as having a contract with a private fee-for-service plan
if the provider, health professional, or other entity furnishes services that are covered under a private fee-for-service plan
, and before providing those services, was informed of the individual's enrollment, and either was informed of the terms and conditions of payment for the services under the private fee-for-service plan
or was given a reasonable opportunity to obtain information concerning the terms and conditions.
The district counters that it wants to use a combination of a fee-for-service plan
as well as a flat fee based on a percentage.
Consumer satisfaction is strikingly high: 87 percent for those in fee-for-service plans
and 85 percent for those in HMOs.
Ware's study, which involved self-reporting by participants rather than diagnostic testing, showed that among elderly patients, 54 percent using HMOs and 28 percent using fee-for-service plans
said that they experienced a decline in physical health.
More than nine-tenths of establishments offering health care offered only one type of plan, with a fee-for-service plan
being the most common plan type offered by itself (See table 4.
In that case, a depressed patient who switched from a fee-for-service plan
to a prepaid plan is estimated to have only about 2/3 of the service use that a similar patient would have who has been in the prepaid sector for a longer time (six actual visits versus nine predicted visits; see Table 3), whereas a new fee-for-service patient uses 11 percent more services than a fee-for-service stayer.
ASIM's legislative agenda reiterates its call for a POS requirement and calls on Congress to ensure that all individuals have a choice of a fee-for-service plan
in any reformed health system.
J Fam Pract 1993; 37:439-44), Dr Millard and colleagues documented that there was no consensus among primary care physicians about which plan is preferred, given a choice between a fee-for-service plan
, a single payer plan, and a managed competition plan.
Rated the best value of any fee-for-service plan
by the Washington Consumer Checkbook's Guide to the FEHBP, the Mail Handlers plan has 510,000 enrollees and covers 1.
Some offer a choice of plans--a fee-for-service plan
, a health maintenance organization (HMO), or a preferred provider organization (PPO), for example.
While the costs are lower and more predictable than under a fee-for-service plan
, there are some drawbacks: