Cost-cutting fervor still spurs HMO/PPO growth.Kaiser Permanente Kaiser Permanente is an integrated managed care organization, based in Oakland, California, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney R. Garfield. , 'the Blues' lead in their categories Southland health maintenance organizations and preferred provider organizations pre·ferred provider organization n. Abbr. PPO A medical insurance plan in which members receive more coverage if they choose health care providers approved by or affiliated with the plan. continue to grow, as employers seek ways to haggle down health care costs. Generally speaking, an HMO HMO health maintenance organization. HMO n. A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial, is a group of doctors and hospitals who agree to provide health care to enrollees, for fixed annual fees. Enrollees are usually employees of companies. A PPO PPO abbr. preferred provider organization PPO Managed care Preferred provider organization, see there Infectious disease Pleuropneumonia-like organism, see there is a list of doctors and hospitals who have agreed to provide health care for discounted, negotiated rates to insurers. In turn, insurers funnel covered employees or others to the PPOs. Both organizational forms are considered to encourage efficiency, compared with traditional fee-for-service indemnity coverage, in which doctors and hospitals merely tote up bills and ask to be paid. Critics have charged that fee-for-service actually encourages spending by health care providers. On this week's List, the largest HMO in Southern California Southern California, also colloquially known as SoCal, is the southern portion of the U.S. state of California. Centered on the cities of Los Angeles and San Diego, Southern California is home to nearly 24 million people and is the nation's second most populated region, remains the industry giant, Kaiser Permanente, which has its own hospitals and doctors. Pasadena-based Kaiser Permanente covers 2.3 million in Southern California, the same number it reported a year earlier. The big HMO has started a multibillion-dollar hospital building program to accommodate new membership in the future. The No. 2 HMO remains Health Net, the Woodland Hills-based providor operated by Chairman Roger Greaves greaves cracklings, an edible raw fat from the meat trade. The skimmings from the preparation of this fat are also called greaves. They represent a low grade of meat meal. . This year Health Net reported 712,490 enrollees in Southern California, up substantially from 601,254 last year. The third-largest local HMO remains Cypress-based Pacificare of California, which reported 615,000 Southland members, compared with 502,000 last year. Although based in Cypress, Pacificare is majority-owned by Burbank-based UniHealth America, where Ross Goldberg heads up communications. On the PPO side, the Southland industry leaders are "the Blues," Blue Cross and Blue Shield Blue Shield A US not-for-profit health care insurer that is a reimbursement intermediary for physicians. Cf Blue Cross. . Woodland Hills-based Blue Cross has more members in all of California, with 1.7 million enrollees, but Blue Shield leads in Southern California, with 777,000 enrollees here, compared with Blue Cross' 755,416 members. Both Blue PPOs have been growing. The third-largest PPO is Long Beach-based Preferred Health Network, with 642,960 local members, compared with 500,000 members a year ago. |
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