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[4] [5] This new health care model was built around a network of participating providers and was a precursor to today's preferred provider organization (PPO). [5] [6] In order to expand its presence in the upstate New York market, GHI established GHI HMO as an incorporated [clarification needed] entity in May 1999. [5]
In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...
Bruce Broussard, former chief executive officer of Humana [13] Richard T. Burke, founder of UnitedHealth, chief executive officer until 1987, and chairman of the board from 2006 to 2017 [14] William H. Donaldson, former chairman, president, and chief executive officer of Aetna [15]
Jim Rechtin, chief executive officer and president of Humana [6] Gail Koziara Boudreaux, chief executive officer and president of Elevance Health [2] Joseph M. Zubretsky, chief executive officer and president of Molina Healthcare [2] Kim Keck, chief executive officer of the Blue Cross Blue Shield Association
Provider-sponsored health plans can form integrated delivery systems; the largest of these as of 2015 was Kaiser Permanente. [30] Kaiser Permanente was the highest-ranked commercial plan by consumer satisfaction in 2018 [31] with a different survey finding it tied with Humana. [32]
Humana pulled out of the acquisition after United stock dropped $2.9 billion in value. [9] In 2001, Humana was a cofounder of Avality. [10] In 2005, Humana entered into a business partnership with Virgin Group, offering financial incentives to members for healthy behavior, such as regular exercise. [11]
The Hawaii Medical Service Association (HMSA) is a member of the Blue Cross Blue Shield Association, an association of independent medical insurance providers. A nonprofit, mutual benefit association founded in 1938, HMSA covers more than half of the state’s population.
Most provider markets (especially hospitals) are also highly concentrated—roughly 80%, according to criteria established by the FTC and Department of Justice [137] —so insurers usually have little choice about which providers to include in their networks, and consequently little leverage to control the prices they pay. Large insurers ...