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Preferred provider organization liability for physician malpractice.

C Butler

    American Journal of Law & Medicine
    |January 1, 1985
    PubMed
    Summary
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    Preferred provider organizations (PPOs) aim to cut healthcare costs. This analysis suggests PPOs face minimal malpractice liability risk for physician negligence, offering insights for healthcare providers and legal professionals.

    Area of Science:

    • Healthcare Law
    • Medical Malpractice
    • Health Economics

    Background:

    • The healthcare industry faces increasing pressure to control costs.
    • Preferred Provider Organizations (PPOs) have emerged as a strategy to manage healthcare expenditures.
    • Understanding the legal risks associated with new healthcare models is crucial.

    Purpose of the Study:

    • To examine potential malpractice liability theories applicable to Preferred Provider Organizations (PPOs).
    • To compare the liability exposure of PPOs with traditional healthcare entities like hospitals and Health Maintenance Organizations (HMOs).
    • To assess the overall malpractice risk for PPOs.

    Main Methods:

    • Analysis of malpractice liability theories.
    • Comparative study of PPOs, hospitals, and HMOs.

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  • Legal review of PPO structures and functions.

    • Main Results:

    • PPOs utilize selective contracting and utilization controls to reduce costs.
    • The study identifies relevant malpractice liability frameworks for PPOs.
    • Comparison indicates a lower risk profile for PPOs compared to other entities.

    Conclusions:

    • Preferred Provider Organizations (PPOs) are subject to malpractice liability considerations.
    • PPOs are structured to minimize direct liability for physician negligence.
    • The risk of PPOs incurring liability for physician negligence is deemed minimal.