Question

Preferred provider organizations (PPOs) are relatively new forms of managed care. Preferred provider organizations are: Select one: a. Physician organized groups that provide discounted medical treatment to underprivileged or disadvantaged groups of people b. Organizations of physicians and other health care professionals who charge a standard, hourly fee for services c. Organizations created by insurance providers which offer medical coverage with doctors inside and outside of the organization's guidelines d. Created by insurance companies via networking with physicians and hospitals in order to provide services in exchange for contractual, discounted, pre-negotiated fees

Answer 1

Solution:

Step 1:

Providing care to the poor in order to provide financial protection and to bring equality in health care some healthcare system offer medical treatment to the underprivileged or disadvantaged groups.

Hence option a is not appropriate.

Step 2:

Physicians or health care professionals offer services to the members on hourly rates for the services. This payment model is called Fee-for-service.

Hence option b is not appropriate.

Step 3:

Preferred Provider Organizations is a managed health care organizations that provide multiple choices in the health care services to the members. Under this, the members can visit the physicians outside the network but need to pay out of their pockets. PPO does not need primary care physicians and members can see a specialist.

Hence option C is correct.

Step 4:

HMO is a Health organization Plan where the members are allowed to visit the physicians only under the network of providers. Under HMO, the premiums can be lowered to the members by the insurers.

Hence the option d is also not appropriate.

Step 5:

The option is C is correct.