Preferred Provider Organizations: Bringing the Mainstream to Medicare?
July 9, 2003
This meeting considered the role of preferred provider organizations (PPOs) in private-sector health insurance and their potential role in Medicare. PPOs’ increasing prevalence and popularity with both health plan sponsors and beneficiaries have led policymakers to incorporate PPO networks into Medicare reform proposals. Speakers addressed PPOs’ appeal in terms of offering broad choice of providers, their ability to control costs and promote quality, benefit design, and physician and hospital recruiting and reimbursement issues. One company’s experience with the Centers for Medicare and Medicaid Services’ PPO demonstration was analyzed.
Tracy Watts, Principal, Mercer Human Resources Consulting; Robert E. Meehan, Vice President, Consumer and Commercial Markets, Horizon Blue Cross Blue Shield of New Jersey; Scott Smith, MD, Chief Medical Officer, First Health, Inc.