Stockbrokers turned into fee based models, I helped them do that 2 decades ago selling no load mutual funds to Advisors. The same will happen with insurance and real estate agents...over time.
When you have guarantee issue health products, PPO plans are magnets for bad health. Obamacare pretty much eliminated PPO plans, or if offered, they are twice the premium vs HMO. I had 10 PPO plans available before ACA, now I have 0 to 1. The same will happen with mapd PPO market. It's a loss leading product, regardless of star ratings or reimbursement amounts.
When you have guarantee issue health products, PPO plans are magnets for bad health. Obamacare pretty much eliminated PPO plans, or if offered, they are twice the premium vs HMO. I had 10 PPO plans available before ACA, now I have 0 to 1. The same will happen with mapd PPO market. It's a loss leading product, regardless of star ratings or reimbursement amounts.