The average deductible is $275 for people in preferred-provider organizations, the most common type of health plan, but for workers in small companies, it is almost $500.

On Monday, the Bush administration issued a separate map showing the regional boundaries for preferred-provider organizations, which steer patients to a network of doctors and hospitals.

Arizona, with 770,000 Medicare beneficiaries, is a separate region for free-standing drug plans and for preferred-provider organizations.

Others would receive their drug benefits through their preferred-provider organizations.

Premiums for these self-directed plans vary, but they tend to be lower than those in health maintenance organizations and preferred-provider organizations.

He expects Medicare to start permitting regional preferred-provider organizations that would offer patients more choices of doctors and hospitals.

These include preferred-provider organizations, individual-practice associations and innovative community or hospital-based health care groups that provide "one-stop" medical care.

The school board's contract proposal would have required all newly hired union members, including teachers, to join a preferred-provider organization to receive medical benefits.

First Health provides management services to corporations, including workers' compensation insurance, through networks of hospitals and doctors in a preferred-provider organization.

Instead, companies are stepping up efforts to shift employees into preferred-provider organizations, plans that are much closer to old-fashioned fee-for-service insurance.