To create flexibility in managed care plans, both HMOs and preferred provider organizations have implemented a(n) ___________ , under which patients have the freedom to use the managed care panel of providers or to self-refer to out-of-network providers. 
a) Exclusive Provider Organization (EPO) 
b) Point-of-Service (POS) 
c) Health Maintenance Organization (HMO) 
d) Preferred Provider Organization (PPO)