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Preferred provider organizations.

The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association

|May 1, 1984

Summary

Preferred Provider Organizations (PPOs) emerged in the 1980s as a new healthcare delivery model, offering discounted services for managed care. PPOs impact healthcare providers, including occupational therapy services.

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Area of Science:

Healthcare Administration
Health Economics

Background:

The 1980s witnessed the emergence of alternative healthcare delivery systems.
Preferred Provider Organizations (PPOs) evolved from the Health Maintenance Organization (HMO) model.
PPOs are prevalent in states like California and Colorado.

Purpose of the Study:

To describe the factors contributing to the development of Preferred Provider Organizations (PPOs).
To explore the implications of PPOs for the practice of occupational therapy.

Main Methods:

This article provides a descriptive overview based on the evolution of healthcare systems.
Analysis of the structural components and agreements within PPO models.

Main Results:

PPOs involve groups of providers (hospitals, doctors) offering services at negotiated, often discounted, fees.
Providers agree to peer review and utilization controls in return for consistent patient volume and prompt payment.
The PPO model represents a significant shift in healthcare contracting and delivery.

Conclusions:

Preferred Provider Organizations represent a key development in alternative healthcare delivery, impacting provider networks and patient access.
Occupational therapy practitioners must understand the PPO framework to navigate its implications for service provision and reimbursement.

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