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preferred provider organization (PPO)
Notes:
1) insurance companies contract with physician groups to provide services at a discounted rate
2) physicians accept the lower rate in anticipation of an increased patient volume
3) the PPO assumes no financial risk - all risk is assumed by the insurance company or the employer
4) patients choose their health care provider from a panel of physicians
5) patients may see specialists without a primary care referral
6) patients may see physicians outside the PPO, but must pay for this privilege - there are strong financial incentives for patients to stay with physicians who belong to the PPO
General
medical organizational structure
References
- Contributions from Linda Kuribayashi MD, Dept of
Medicine, UCSF Fresno
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998