tci Medicare Compliance & Reimbursement - 2003 Issue 40

Medicare PPO Demo: PPO DEMO MOSTLY SERVES SAME AREAS AS M+C HMOs

With congressional negotiators debating how to involve more preferred provider organizations in Medicare, all eyes may soon be on the Centers for Medicare & Medicaid Services' demo designed to determine how best to pay and manage PPOs in Medicare. Much of the interest in attracting PPOs is tied to the hope that, with their less stringent requirements for assembling provider networks, the bigger, more loosely managed health plans would be a natural option for rural areas where few Medicare health maintenance organizations have established themselves. Launched at the beginning of 2003, the demo's enrollment is still low, however. And...

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