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Exclusive provider organizations (EPOs) are managed care plans that provide benefits to subscribers if they receive services from:

a. case managers
b. network providers
c. the Office of Managed Care
d. medical foundations

1 Answer

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Final answer:

EPOs offer benefits when subscribers receive services from network providers. They contrast fee-for-service models by incentivizing efficient patient management due to fixed reimbursements per patient in managed care systems like HMOs.

Step-by-step explanation:

Exclusive provider organizations (EPOs) are managed care plans that provide benefits to subscribers if they receive services from network providers. They are an alternative to traditional fee-for-service health financing systems where medical care providers get reimbursed based on the services they provide. EPOs tend to offer a network of providers for a subscriber to choose from, and if care is obtained outside of this network, it might not be covered or could come with significantly higher out-of-pocket costs to the subscriber. In managed care systems, organizations such as health maintenance organizations (HMOs), operate on a fixed reimbursement per patient, incentivizing providers to manage patients efficiently, which contrasts with the fee-for-service model.

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