Some general statements can be made about the similarities and differences between PPOs and coalitions. However, since coalitions and PPOs vary considerably, each prospective coalition member or PPO customer should investigate each PPO or coalition option and make decisions with its own interests being the sole consideration. Trustees have a fiduciary responsibility to explore all options for reducing costs, including joining a health care coalition. A health care coalition is a membership organization established by purchasers, whether employers or union-management jointly administered funds, to use their collective purchasing strength to negotiate more effectively with medical providers and insurers.
Coalitions offer patient volume and administrative efficiencies in exchange for negotiated fees.
PPOs and health care coalitions are not mutually exclusive options. Health care coalitions often use their collective strength to negotiate on behalf of members for discounted access to PPO networks and services. A fund or employer member of a coalition, then, may also be a PPO customer. In other instances, a coalition member may take advantage of some coalition offerings while separately contracting with a PPO for other services. For example, a coalition member may choose to participate in a coalition's directly contracted network for general medical services while contracting separately with a PPO for dental, vision or other services.