tci Medicare Compliance & Reimbursement - 2004 Issue 19

Health Plans: Can PPOs Really Save Medicare?

PPOs may not be up to the challenge, new study says.Based on the experience of preferred provider organizations in the private sector, PPOs may not be able to perform all the tasks lawmakers set for them in last year's Medicare legislation. That's the finding of a report from the nonpartisan research group Center for Studying Health System Change (HSC), based on interviews from HSC's latest round of site surveys in 12 health-care markets. By promoting development of a large-scale PPO sector in Medicare, legislators hoped to offer beneficiaries sustainable coverage options with more benefits and lower out-of-pocket...

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