ORGANIZING AND OPERATING A PREFERRED PROVIDER ORGANIZATION: A SUMMARY
Introduction to the Summary of the Paper
This paper reviewed the major issues that must be dealt with in the creation and operation of a managed care network. The type of managed care network considered in this paper was a preferred provider organization (PPO). The specific type of PPO examined in this paper was a physician-sponsored network (PSN).
This paper was structured into two major sections in addition to the ôIntroductionö and ôConclusion.ö The first major section in the paper examined the major issues that are involved in the organization of a PSN. The second major section reviewed the major issues that must be faced in the operation of a PSN once the managed care network has been established.
The rest of this summary covers each of the four sections of the paper. These sections are the ôIntroduction,ö ôOrganizational Concerns,ö ôOperational Concerns,ö and the ôSummary and Conclusion.ö
Summary of the Introduction to the Paper
The ôIntroductionö to the paper reviewed briefly the changes in the health care environment in the United States that caused government, health insurance companies, employers, and others to begin looking for ways to reduce the growth in health care costs. One outcome of this search was the managed care concept, which is the basis for this paper. The ôIntroductionö also covered some of the disputes related to the managed care concept it self.
Summary of the Organizational Concerns Section of the Paper
With respect to the organization of a managed care network, three major areas of interest were reviewed. These interest areas were licensure, health care service distribution channels, and the negotiation of participation agreements. These three areas are not the only ones that must be dealt with in the organization of a PSN, but they are the areas that hold the greatest potential for the mak...