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Thatch details the key differences between PPO and EPO health insurance plans.
PPO. The Preferred Provider Organization plan is the most popular for those with employment-based insurance (currently 47% of them, in fact). PPOs allow the most flexibility in that people can ...
In 1980, an early PPO was organized in Denver at St. Luke's Medical Center at the suggestion of Samuel Jenkins, [3] an employee of the Segal Group who consulted with hospitals for Taft-Hartley trust funds. [4]: 6 By 1982, 40 plans were counted and by 1983 variations such as the exclusive provider organization had arisen. [3]
Managed care plans and strategies proliferated and quickly became nearly ubiquitous in the U.S. However, this rapid growth led to a consumer backlash. Because many managed care health plans are provided by for-profit companies, their cost-control efforts are driven by the need to generate profits and not providing health care. [5]
In the United States, an exclusive provider organization (EPO) is a hybrid health insurance plan in which a primary care provider is not necessary, but health care providers must be seen within a predetermined network. Out-of-network care is not provided, and visits require pre-authorization.
Both plan types use a network of healthcare services. The main difference between them is the way the insured person can use those networks. View the table below for a comparison of HMO and PPO plans.
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