Kaiser Permanente, Health Care compare top HMO/PPO rankings.The big grandaddy gran·dad·dy n. Variant of granddaddy. of health maintenance organizations, the 2.3-million-member 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. , maintained its No. 1 rating among Southland HMOs in this year's List of the 15 largest HMOs serving L.A. County. Industry behemoth behemoth (bē`hĭmŏth, bĭhē`–) [Heb.,=plural of beast], large, fanciful primeval monster, like Leviathan, evoking the hippopotamus mentioned in the Book of Job. Kaiser owns and operates hospitals, and has staff doctors, through a contract with a physicians group. While its Southland membership is the biggest, the Pasadena-based Kaiser Permanente is not now growing; its reported membership is unchanged from last year. The second-largest 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 Roger Greaves' Health Net, the Woodland Hills-based outfit that converted to profit from non-profit last year. Health Net is also not growing 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, , reporting 707,806 members here this year, slightly less than last year's tally. As with Kaiser, its ranking is unchanged from last year. The No. 3 HMO, Pacificare of California, is growing, rising to 650,000 members from 615,000 in the Southland last year. Despite the growth, the for-profit Cypress-based Pacificare's ranking from last year is unchanged. A new HMO in the top 10 is Managed Health Network, with 389,541 members in Southern California. Managed Health was not on The List last year. This year's List is ranked by number of members in Southern California, which is defined as Los Angeles Los Angeles (lôs ăn`jələs, lŏs, ăn`jəlēz'), city (1990 pop. 3,485,398), seat of Los Angeles co., S Calif.; inc. 1850. , Orange, Ventura, San Bernardino San Bernardino, city, United States San Bernardino (săn bûr'nədē`nō), city (1990 pop. 164,164), seat of San Bernardino co., S Calif., at the foot of the San Bernardino Mts.; inc. 1854. , Riverside, Imperial and San Diego San Diego (săn dēā`gō), city (1990 pop. 1,110,549), seat of San Diego co., S Calif., on San Diego Bay; inc. 1850. San Diego includes the unincorporated communities of La Jolla and Spring Valley. Coronado is across the bay. counties. Last year's List was ranked by number of members in the entire state of California. No HMO on last year's List disappeared from this year's, in part because The List was expanded to 15 this year, compared with 10 last year. On the PPO PPO abbr. preferred provider organization PPO Managed care Preferred provider organization, see there Infectious disease Pleuropneumonia-like organism, see there side of the ledger, the No. 1 plan is the Huntington Beach-based Health Care Compare Corp., a for-profit with 1.11 million members in Southern California, up from 950,000 last year, according to The List of the largest PPOs operating in the county. What's the difference between an HMO and a PPO? The distinctions have been blurred over the years, but basically, an HMO covers members prospectively -- that is, an HMO bills its clients monthly, and also pays providers on a monthly basis, per patient enrolled. In an HMO, a group of doctors may agree to cover 10,000 patients for the year, for a set monthly fee. In a PPO arrangement, providers bill the PPO per operation or treatment, but usually at agreed upon rates, frequently considered discounted rates. There is no monthly limit on billings, either per patient or for a covered group. The No. 2 PPO on this year's List is Santa Ana-based Admar Corp. with 1.02 million enrollees in Southern California. Admar is growing; it reported only 731,228 members last year. Long Beach-based Preferred Health Network is the third-largest PPO in Southern California, with almost exactly 1 million members in Southern California, up strongly from 642,960 a year ago. No PPO on last year's List disappeared from this year's, in part because The List was expanded to 15 from 10. |
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