preferred provider organization (PPO)

Notes

• insurance companies contract with physician groups to provide services at a discounted rate
• physicians accept the lower rate in anticipation of an increased patient volume
• the PPO assumes no financial risk - all risk is assumed by the insurance company or the employer
• patients choose their health care provider from a panel of physicians
• patients may see specialists without a primary care referral
• 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

More general terms

• medical organizational structure