what is a provider sponsored organization?course hero

A Provider-Sponsored Organization (PSO) is a type of Medicare Advantage Plan that is operated by a group of doctors and hospitals that form a network of providers within which you must stay to receive coverage for your care. This type of plan is not available in most parts of the country. « Back to Glossary Index

Full Answer

What is Provider Sponsored Organization?

Provider sponsored organizations (PSOs) are health care delivery networks owned and operated by providers. They contract to deliver health care services to licensed health plans, self-insured employers, and other group purchasers. PSOs often assume the risk that members of the groups will need health care services.

What is the structure behind Provider Sponsored Organization model?

A Provider-Sponsored Organization (PSO) is a type of Medicare Advantage Plan that is operated by a group of doctors and hospitals that form a network of providers within which you must stay to receive coverage for your care. This type of plan is not available in most parts of the country.

Is HMO a gatekeeper or open access?

Some coverage may be available out-of-network. HMO (Health Maintenance Organization): The primary care physician is the gatekeeper.

Which type of HMO contracts health services that are delivered to subscribers by physicians who remain in their own office settings?

Also called independent practice association (IPA) HMO, contracted health services are delivered to subscribers by physicians who remain in their independence office settings.

What does PSO mean in health care?

Patient Safety OrganizationsPurpose. Patient Safety Organizations (PSOs) conduct activities to improve the safety and quality of patient care.

What are the benefits for Provider Sponsored organization?

Although organizations have different reasons for wanting to enter the insurance business, potential benefits include improving care quality, lowering costs, managing population health, expanding geographic reach, and diversifying the organization's revenue stream.

Why does HMO exist?

The definition of an HMO has its origins in fire safety legislation, following a series of publicised, preventable deaths in overcrowded buildings.

What is the 3 to 11 rule in health care?

What is the "3 to 11" rule? For every good thing that happens we tell 3 people for every bad thing we tell 11. What are professional behaviors off a Healthcare worker?

Which is better PPO or HMO?

HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.

What organization is owned by hospitals and physician groups that obtain managed care plan contracts?

A physician-hospital organization (PHO) is owned by hospital(s) and physicians groups that obtain managed care plan contracts.

Is an organization of physicians and other health care professionals that provides health care services to subscribers on a prepaid basis?

An HMO is a prepaid health care delivery system in which a physician, hospital, or other provider contracts to provide basic health care services to enrollees of the plan on a prepaid basis, except for enrollee responsibility for co-payments or deductibles.

Which is associated with contracted health care services that are delivered to subscribers by individual physicians in?

Which is associated with contracted health care services that are delivered to subscribers by individual physicians in the community? An integrated provider organization (IPO) manages the delivery of health care services offered by hospitals, physicians, and other health care organizations.