Assessing PPO Performance on Prevention and Population Health

Abstract

This article compares preferred provider organization (PPO) and health maintenance organization (HMO) performance on the utilization of and consumer satisfaction with preventive care. Surveys were conducted of California health plans, employers, and the insured population collected between 1996 and 1999. The authors found that PPOs were less likely than HMOs to cover some types of preventive care. PPO enrollees were less likely than HMO enrollees to receive blood pressure and mammography screenings or preventive counseling on gun safety, smoking, and sexually transmitted disease or HIV prevention. PPO enrollees were less satisfied with preventive care than HMOs enrollees. The authors concluded that there are significant differences between the rates at which preventive care is delivered in PPOs and HMOs, which can be understood in the context of PPO benefit plan design, and differences in their structural and financial characteristics. This suggests specific strategies through which it might be possible to improve preventive health care and promote population health among employees enrolled in PPOs.