Special-interest groups representing hospitals and insurers agree that few consumers know the difference between HMOs and provider-sponsored organizations, but they disagree on whether that means consumers want HMOs and PSOs regulated differently.
According to a report released last week by the national Blue Cross and Blue Shield Association, consumers see no difference between HMOs and PSOs. The report is based on focus groups convened by the Blues group.
The report concluded: "There is no perceived difference between PSOs and HMOs and, as a result, no reason to regulate them any differently."
The insurance industry wants PSOs, which would contract directly with Medicare for care to beneficiaries, regulated under the same rules established for traditional insurance companies.
Richard Wade, the American Hospital Association's senior vice president for communication, said the results of the AHA's own consumer focus groups show consumers see little difference between HMOs and PSOs.
But, Wade said, the AHA's polling data reveal that consumers like the concept of provider ownership of PSOs because they "have a deep distrust of the insurance community."
In the AHA's view, that means consumers would support more lenient oversight of PSOs to spur their development and growth.
Provider groups and insurers are locked in a bitter struggle over how PSOs should be regulated. The balanced-budget plan being debated in Congress calls for the development of PSOs, but the details, such as whether the state or federal government will oversee the provider networks and under what solvency and quality standards, must still be worked out.