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Since my company MedSave.com doesn't handle HMOs and Ipersonally don't [link widoczny dla zalogowanych] like them, I skipped that section. The reporton PPOs is likely to be much more interesting to most individualor small businesses buyers of health insurance. Certainly HMOsare the right answer - or even the only answer - in somesituations, but I just think that "quality shopping for a HMO"is an oxymoron. But the flexible design of PPO plans in today'smarket makes it is more likely that a shopper will find anattractive value in a PPO plan rather than in an HMO.
Most health plans today offer a variety of PPO network choices,and it is often possible to use more than one PPO network withina single health insurance plan. In some locations a small localPPO may be strong choice, but might not even be listed in the CRrating system due to its size. Often an individual or smallbusiness located in a rural area may wisely select a PPO basedsolely on the participation of the dominant hospital system intheir own community despite a lower rating in the CR survey.
Consumer Reports published a review of Health MaintenanceOrganizations (HMO) and Preferred Provided Organizations (PPO)health plans in their October 2001 issue. The report isavailable free online. Like most other CR reports, you have tobe knowledgeable in the subject material and really read betweenthe lines to get the true value of the ratings report.
The most attractive feature of the PHSC health network plans isthat they often can be combined with other cost-saving plandesign [link widoczny dla zalogowanych] features like preferred-risk and preferred-industrydiscounts, high deductible plans and Medical Savings Accounts.With high deductible plans, keep in mind that you still benefitfrom direct in-network claims processing and substantialprovider [link widoczny dla zalogowanych] discounts even if your bill is lower than the policydeductible. A benefits consultant can design a plan to fitalmost any budget simply by adjusting the levels of insurancecoverage.
Six of the seven top-ranked PPO networks are operated by localBlue Cross associations. This is good news unless you happen tobe among of the majority of Americans [link widoczny dla zalogowanych] who does not live in oneof these six geographic service regions, or you can't afford thegenerally high costs that come with a [link widoczny dla zalogowanych] premium Blue Cross/BlueShield health plan. This is the most significant result of theCR report: Blue Cross PPO networks are doing a good jobsatisfying their members. Certainly these are premium-care,premium-cost plans. Unfortunately, with average family premiumswell above $700 per month, many individual and small businessbuyers simply cannot afford the cost of these plans.
It has always been difficult for consumers who purchase healthinsurance to find meaningful data on [link widoczny dla zalogowanych] the quality of theavailable plans. It has been even [link widoczny dla zalogowanych] more difficult, I think, for ahealth insurance buyer to translate the published data intoconclusions relevant to their own [link widoczny dla zalogowanych] purchasing situation sincemost individual and small business purchasers have differentconcerns than the majority of employees of larger [link widoczny dla zalogowanych] corporations.Much of the available data just is not relevant to individualsand small businesses. But now the "king of all ratings" -Consumer Reports Magazine - has spoken on the issue of healthinsurance plans, I think it makes sense to defer to them andconsider [link widoczny dla zalogowanych] how this well-known [link widoczny dla zalogowanych] rating system might be useful forbuyers of [link widoczny dla zalogowanych] health plans.
The highest-ranking private national PPO plan was PrivateHealthcare Systems (PHCS). This was great to see because I'vealways recommended PHCS and personally felt they [link widoczny dla zalogowanych] were the bestoption for the largest group of buyers, but I had no hardevidence to back up this opinion.
In any event, I think that most of us would agree that "morenews is good news" when it comes to providing public informationabout the quality of our nation's health insurance plans.
PHCS health plans are available in some [link widoczny dla zalogowanych] form to everyone in all50 states through a variety of insurance plans and uninsuredplans. The insurance plans are available to perhaps 80% of smallbusinesses and 50% of healthy individuals, but individuals withhealth problems will have trouble [link widoczny dla zalogowanych] finding one of these plans.Beware of the uninsured "discount plans". The concept is good,but the price is not. It is highly unlikely that this is a goodfinancial deal for any buyer. Unfortunately these plans arehyped on the Web and junk e-mail to the point where we cannotseem to get away from them.