RTI Press Research Report
Where do HMOs and PPOs locate? Debunking an urban myth
Grefer, J., Mobley, L.R., & Frech, H.E. (March 2009).
Because of network restrictions, health maintenance organizations (HMOs) are most effective, and thus are predominantly located, in urban areas where there are many physicians and medical facilities to form networks. Preferred provider organizations (PPOs) on the other hand are effective outside of urban areas as well because they are less restrictive, according to a new study by researchers at RTI International, CNA and the University of California.
The study also found that fee-for-service plans can survive anywhere because they do not impose restrictions on provider choice. The study was based on data from California hospital discharges in 1998, a time when PPO and HMO insurance types were coded separately.
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Permanent Link: doi:10.3768/rtipress.2009.rr.0004.0903
Full Citation: Grefer, J., Mobley, L.R., & Frech, H.E. (March 2009). Where do HMOs and PPOs locate? Debunking an urban myth. RTI Press Publication No. RR-0004-0903.
Abstract
Because of network restrictions, health maintenance organizations (HMOs) are most effective, and thus are predominantly located, in urban areas where there are many physicians and medical facilities to form networks. Preferred provider organizations (PPOs) on the other hand are effective outside of urban areas as well because they are less restrictive, according to a new study by researchers at RTI International, CNA and the University of California.The study also found that fee-for-service plans can survive anywhere because they do not impose restrictions on provider choice. The study was based on data from California hospital discharges in 1998, a time when PPO and HMO insurance types were coded separately.
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