Institute:Office of National Coordinator (ONC) Workforce Training Curriculum
Component:Introduction to Health Care and Public Health in the U.S.
Unit:Financing Health Care - Part 1
Lecture:Payors in the U.S. Health Care System
Slide content:Cost vs. Provider Choice Various plans are defined by choices in what providers the patient can use Fewer choices = lower premiums and out-of-pocket costs Types of plans: Health maintenance organization (HMO) Preferred provider organization (PPO) Exclusive Provider Organization (EPO) Point-of-service plan (POS) 16
Slide notes:Managed care plans differ with regard to the number of choices its members have, which has a direct relationship to health care costs. Fewer choices, usually in the form of restricting a patients selection of health care providers, translates to lower insurance premiums and lower out-of-pocket costs. However, some people prefer the freedom to choose their own doctors. This choice, and the additional costs involved, is an important issue. There are three types of managed care plans: health maintenance organizations, or HMOs; preferred provider organizations, or PPOs; and point-of-service plans, or POSs. A variation of the PPO is the exclusive provider organization or EPO. The next slides will detail the varying degrees of choice and cost in each of these models. 16