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Preferred provider organizations.

J D Davy

    The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association
    |May 1, 1984
    PubMed
    Summary
    This summary is machine-generated.

    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.