Preferred Provider Organizations (PPOs)

Preferred Provider Organizations
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Preferred provider organizations (PPOs) is an insurance plan that has allowed me to elect alternative in-network providers for their specialty and primary care needs. My experience with the plan is not promising despite allowing me to see different within-network specialty care providers without requiring a referral. PPOs are not without limitations. First, although the program enables patients to visit out-of-network healthcare professionals, they will need to incur additional costs compared in that respect compared to their mainstream in-network providers (Heaton & Tadi, 2023). This problem relates to PPOs' inability to support transparency in controlling costs and charges as the patient moves from one provider to another (Kelly, 2019). Second, prices are usually higher because of the augmented flexibility of the plan (Heaton & Tadi, 2023). PPOs cannot manage price changes across hospitals, health systems, and procedures (Kelly, 2019). Research indicates that many Americans cannot afford medical insurance, and they face significant cost-related barriers despite insurance coverage (Crowley et al., 2020). These cost-associated barriers can be attributed to PPOs' inflated cost structure and lack of transparency in pricing across the health care continuum...