View source for Exclusive provider organization

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In the [[United States]], an '''exclusive provider organization''' ('''EPO''') is a hybrid [[health insurance]] plan in which a [[primary care provider]] is not necessary, but health care providers must be seen within a predetermined network. Out-of-network care is not provided, and visits require pre-authorization. Doctors are paid as a function of care provided, as opposed to a [[health maintenance organization]] (HMO). Also, the payment scheme is usually [[fee for service]], in contrast to HMOs in which the healthcare provider is paid by [[Capitation (healthcare)|capitation]] and receives a monthly fee, regardless of whether the patient is seen.<ref>{{cite web|title=EPO Health Insurance—How It Compares to HMOs and PPOs|last=Davis|first=Elizabeth|website=HealthInsurance.About.com|url=http://healthinsurance.about.com/od/understandingmanagedcare/fl/EPO-Health-Insurance-How-It-Compares-to-HMOs-and-PPOs.htm|accessdate=Jan 15, 2014|archive-date=March 7, 2014|archive-url=https://web.archive.org/web/20140307141929/http://healthinsurance.about.com/od/understandingmanagedcare/fl/EPO-Health-Insurance-How-It-Compares-to-HMOs-and-PPOs.htm|url-status=dead}}</ref>
== History ==
Exclusive provider plans existed as early as 1983 as a variation of preferred provider plans, which emerged in the early 1980s.<ref>{{Cite journal|last=Katz|first=Cheryl|date=June 1983|title=Preferred Provider Organizations|journal=Postgraduate Medicine|volume=73|issue=6|pages=143–146|doi=10.1080/00325481.1983.11697868|issn=0032-5481}}</ref>
==See also==
* [[Patient Protection and Affordable Care Act]]
* [[Preferred provider organization]]
==References==
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[[Category:Health insurance in the United States]]