Which of the following is described when a selected group of practitioners, in a certain area, agrees to provide services at a pre-arranged cost on a fee-for-service basis?

Rationale

Preferred provider organization describes a selected group of practitioners agreeing to provide services at a pre-arranged cost on a fee-for-service basis.

In a preferred provider organization (PPO), healthcare providers come together to offer services to a specific group of patients at negotiated rates, emphasizing both cost control and access to a network of providers.

A (preferred provider organization) CORRECT

A preferred provider organization is a managed care system where a network of healthcare providers agrees to deliver services at reduced costs for plan members. This arrangement allows patients to receive services from preferred providers at lower out-of-pocket expenses, making healthcare more affordable and accessible.

B (indemnity organization) YOUR ANSWER

An indemnity organization refers to a type of health insurance plan that offers the insured the freedom to choose any healthcare provider without a network restriction. The insurer reimburses the insured for a portion of the costs, which differs from the fee-for-service arrangements in PPOs and lacks the structured cost agreements among practitioners.

C (risk purchasing group) YOUR ANSWER

A risk purchasing group is a collective of individuals or businesses that come together to purchase insurance as a group to reduce costs and improve coverage options. This concept focuses on pooling resources for better rates rather than establishing a network of providers that agree on pre-arranged service costs.

D (coalition group) YOUR ANSWER

A coalition group generally refers to a collaborative partnership among various organizations or stakeholders aimed at addressing specific issues or goals. This term does not specifically imply a structured healthcare service delivery system with pre-arranged costs, which distinguishes it from the defined nature of a preferred provider organization.

Conclusion

A preferred provider organization is characterized by a network of healthcare practitioners who agree to offer services at predetermined costs, creating a structured and cost-effective healthcare delivery model. In contrast, the other options do not encompass this specific arrangement and thus do not accurately describe the concept of practitioners providing services on a fee-for-service basis.

Which of the following is described when a selected group of practitioners, in a certain area, agrees to provide services at a pre-arranged cost on a fee-for-service basis?

Preferred provider organization describes a selected group of practitioners agreeing to provide services at a pre-arranged cost on a fee-for-service basis.

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