Compare and contrast the HMO, PPO, and POS models
In an HMO, patients have no choice in the physician or facility. In a PPO, patients receive care from a provider who can perform a procedure or provide a service in the most cost-effective manner. Providers agree to provide services to PPO patients at a discounted rate in return for the promise of a higher volume of patients. The patient has minimal out-of-pocket expenses. In a POS, the individual can use a care provider outside of the preferred network. Coverage for services rendered by an out-of-network provider is reimbursed at a lesser rate in keeping with the PPO model. The patient is responsible for paying the remaining charges and copays resulting from using a provider outside of the preferred group.
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