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How can one HMO company charge different rates for the same coverage in different counties in PSERS HOP?

April 26, 2017charge COMPANY counties coverage different hmo hop PSERS rates

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How can one HMO company charge different rates for the same coverage in different counties in PSERS HOP?

1 Answer

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10 Posted

HMO rates are based on the community’s experience and the Health Care Financing Administration’s (HCFA) reimbursement rate that is calculated for each county. HMOs make the final decision on the rates they charge. Where possible HOP offers more than one HMO in an area to foster competition.