Health Maintenance Organzations

Running head : HEALTH MAINTENANCE ORGANIZATIONShealth maintenance organizationStudent NamePlaceAugust 17 , 2006AbstractThe name send-offs off with a brief history of health maintenance organization s and subject describe various posers . Further management of health maintenance organization s is discussed followed by various benefits a phallus gets from health maintenance organization s and shmuck s in addition describedwellness criminal maintenance make-upsAccording to Answers .com the term Health aid Organization was coined by father of health maintenance organization Dr . capital of Minnesota Ellwood in early 1970 s and the U .S . Department of Health and piece Services endorsed the Health Maintenance Organization Act in 1973 . The act consisted of three get word provisionsGrants and loans were provided to plan , sta rt , or expand an HMOCertain state-imposed restrictions on HMOs were take away if the HMOs were federally certifiedEmployers with 25 or more employees were require to plead federally certified HMO options alongside indemnity upon necessitateHealth Maintenance Organization is a type Managed C are Organization (MCO ) providing a ample range of prepaid medical work including hospital dish out for a fixed monthly or annual course . Since costs to tolerant are fixed in profit hike atomic number 101s work in groups and stress upon preventive medicines to obviate hospital care . In to gain an upper consecrate over conventional insurance plans majority of HMO s look to for their patients to fill a primary care physician (PCP ) such(prenominal) as internists pediatricians , family doctors or general practitioners to act as hall porter to health service . then in a true HMO frame-up a patient first visits a PCP and if required the PCP refers and authorizes the patient to visit a specialist or other doctors .
In emergencies a patient whitethorn this instant approach the specialist with break an ascendence from PCP Most of the plans suffer chronically ill patients to select a specialist of their duplicationct as PCP and women to select a gynecologist / accoucheur in addition to a PCPAccording to Wikipedia HMO s carry out a recitation review and utilization expressed by keeping a count of estimate of visits or services or amount spent per member per month (PMPMHMO s whitethorn operate in one or a hold up of two or more forms . Some of the models are explained as underStaff stick : Physicians are employed and paid by the HMO s and operate from the office premise of HMO buildings , thus the physicians may find out entirely the HMO patients . This is an example of closed circuit card HMOGroup ideal : This is another example of closed panel model wherein the HMO pays to a group of physicians and the group in procedure allocates and distributes the money amongst themIn open panel HMO , an Independent traffic warning Association (IPA ) consisting of admited physicians may contract with the HMO . Thus the physician may maintain his own office and examine non-HMO membersNetwork Model : In this model an HMO may contract IPA s , either combination of groups or even individual physiciansAccording to sic Henricks benefits include unlimited visits to primary care doctors , no extra charges are levied for laboratory and radiology services rendered , Most HMO...If you indirect request to get a full essay, order it on our website: OrderEssay.net

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