Blue Cross and Blue Shield of Arizona Medicare Physician PPO Demonstration Status Report

摘要

The report provides a detailed description of the Medigap Preferred Provider Organization (PPO) developed by Blue Cross and Blue Shield of Arizona (BCBS/AZ) and describes its early operational experience. The description includes an overview of BCBS/AZ and its market area, its history, its experience with the PPO concept in the private sector, and its reasons for developing a Medigap PPO. The report also examines the following major topics; design of the benefit package, marketing approaches, the criteria and process for selecting network providers, utilization management procedures, and quality assurance procedures.