Preferred Provider Organizations - Economics
Research News and Information

Sunday, November 22, 2009

The price is now right. UnitedHealth Group's settlement on benchmarking databases could make out-of-network care costs more transparent, equal, some say.

17 Jan 2009 Disagreement surrounds the discussion of whether the demise of two Ingenix price databases will aid the provider-payer relationship. Karen Ignagni, AHIP's CEO, questions the objective, wondering why in some cases "billings so exceed reimbursement." ... Read more...

Consumer channeling by health insurers: natural experiments with preferred providers in the Dutch pharmacy market.

28 Feb 2008 Consumer channeling is an important element in the insurer-provider bargaining process. Health insurers can influence provider choice by offering insurance contracts with restricted provider networks. Alternatively, they can offer contracts with ... Read more...

Patient outcomes and evidence-based medicine in a preferred provider organization setting: a six-year evaluation of a physician pay-for-performance program.

29 Nov 2007 OBJECTIVE: To determine whether health plan members who saw physicians participating in a quality-based incentive program in a preferred provider organization (PPO) setting received recommended care over time compared with patients who saw ... Read more...

Latest indexed articles for 'Preferred Provider Organizations - Economics'

These are the very latest articles for this heading:

• The price is now right. UnitedHealth Group's settlement on benchmarking databases could make out-of-network care costs more transparent, equal, some say. 17 Jan 2009
• Top 10 tips for a recession-proof practice. 30 Jul 2008
• What's behind the veil? 29 Apr 2008
• Consumer channeling by health insurers: natural experiments with preferred providers in the Dutch pharmacy market. 28 Feb 2008
• Calif. wants another slice of UnitedHealth pie. PacifiCare violations could cost insurer up to $1.3 billion. 2 Feb 2008
• Round three. 30 Jan 2008
• Mass. Blues floats flat-fee plan. 26 Jan 2008
• Patient outcomes and evidence-based medicine in a preferred provider organization setting: a six-year evaluation of a physician pay-for-performance program. 29 Nov 2007
• Using performance data to identify preferred hospitals. 29 Nov 2007
• Dental practice satisfaction with preferred provider organizations. 13 Nov 2007
• Shifting the curve: an argument against tiered networks. 30 Jul 2007
• Trends in the golden state: small-group premiums rise sharply while actuarial values for individual coverage plummet. 12 Jun 2007
• Medicare Advantage in 2006-2007: what Congress intended? 13 May 2007
• Keeping a tight rein. 30 Mar 2007
• Economic grand rounds: A pay-for-performance program for behavioral health care practitioners. 30 Mar 2007
• Overcoming information asymmetry in consumer-directed health plans. 30 Mar 2007
• Shopping for price in medical care. 4 Feb 2007
• HMO cost trends lower than PPOs; uptake stalls in consumer-driven health plans. 30 Jan 2007
• Do payers really want transparency in health care? 30 Dec 2006
• Consumer-directed health plans: new evidence on spending and utilization. 30 Dec 2006

See a longer list of these articles.

Technical information about 'Preferred Provider Organizations'

Definition: Arrangements negotiated between a third-party payer (often a self-insured company or union trust fund) and a group of health-care providers (hospitals and physicians) who furnish services at lower than usual fees, and, in return, receive prompt payment and an expectation of an increased volume of patients.

Descriptor UI: D011243

Alternative terms: Preferred Provider Organizations; Preferred Provider Organization; Organizations, Preferred Provider; Organization, Preferred Provider;

Allowable Qualifiers: classification; economics; history; legislation & jurisprudence; manpower; organization & administration; standards; trends; utilization; statistics & numerical data; ethics;

Tree Number: N03.219.521.576.343.800.750; N04.590.374.410.750;

Online Note: use INSURANCE, HEALTH to search PREFERRED PROVIDER ORGANIZATIONS 1984

History Note: 91(85); was see under MANAGED CARE PROGRAMS 1990; was see under INSURANCE, HEALTH 1985-89; was see INSURANCE, HEALTH 1984

Technical Notes: specify geog if possible; DF: PPO