Biomaterial Database

PPOs: forces which will determine their growth and future. 1987

N R Cates

PPOs are designed to promote competition among providers for the purpose of enhancing cost containment. Business and industry have demonstrated an active interest in PPOs and report savings as a consequence of purchasing health services for employees from these new alternative care organizations. To be effective in reducing the rate of escalation of personal health care expenditures will require demonstration to the business community that they are able to provide quality care at less cost. This will require a strong utilization review program and a need for providers to share some risk as an incentive to be cost efficient. Furthermore, any federal or state legislation or regulation should discourage overburdensome costs for PPOs to do business.

UI	MeSH Term	Description	Entries
D007348	Insurance, Health	Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.	Group Health Insurance,Health Insurance,Health Insurance, Voluntary,Health Insurance, Group,Health Insurances,Insurance, Group Health,Insurance, Voluntary Health,Insurances, Health,Voluntary Health Insurance
D011243	Preferred Provider Organizations	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.	Organizations, Preferred Provider,Preferred Provider Organization,Organization, Preferred Provider
D003363	Cost Control	The containment, regulation, or restraint of costs. Costs are said to be contained when the value of resources committed to an activity is not considered excessive. This determination is frequently subjective and dependent upon the specific geographic area of the activity being measured. (From Dictionary of Health Services Management, 2d ed)	Cost Containment,Containment, Cost,Containments, Cost,Control, Cost,Controls, Cost,Cost Containments,Cost Controls
D004465	Economic Competition	The effort of two or more parties to secure the business of a third party by offering, usually under fair or equitable rules of business practice, the most favorable terms.	Competition, Economic,Competitions, Economic,Economic Competitions
D005544	Forecasting	The prediction or projection of the nature of future problems or existing conditions based upon the extrapolation or interpretation of existing scientific data or by the application of scientific methodology.	Futurology,Projections and Predictions,Future,Predictions and Projections
D014481	United States	A country in NORTH AMERICA between CANADA and MEXICO.
D014485	United States Federal Trade Commission	An independent administrative agency concerned with maintaining competitive free enterprise by prohibiting unfair methods of competition and unfair deceptive acts or practices.	Federal Trade Commission (U.S.),USFTC,Federal Trade Commission
D014600	Utilization Review	An organized procedure carried out through committees to review admissions, duration of stay, professional services furnished, and to evaluate the medical necessity of those services and promote their most efficient use.	Review, Utilization,Reviews, Utilization,Utilization Reviews