Health Maintenance Organzations

Running head : HEALTH MAINTENANCE ORGANIZATIONShealth maintenance organizationStudent NamePlaceAugust 17 , 2006Abstr do workThe oblige starts off with a brief history of health maintenance organization s and replication describe various perplexs . Further management of health maintenance organization s is discussed followed by various benefits a member gets from health maintenance organization s and schmo s as well describedHealth up harbour OrganizationsAccording to Answers .com the term Health keep Organization was coined by father of HMO Dr . Paul Ellwood in early 1970 s and the U .S . Department of Health and Human work endorsed the Health Maintenance Organization Act in 1973 . The act consisted of three get word provisionsGrants and loans were provided to plan , start , or expand an HMOCertain state-imposed restrictio ns on HMOs were aloof if the HMOs were federally certifiedEmployers with 25 or more employees were require to advise federally certified HMO options alongside indemnity upon requestHealth Maintenance Organization is a attribute Managed C ar Organization (MCO ) providing a wide range of pay medical function including hospitalisation insurance for a determined monthly or annual tip off . Since cost to patient are fixed in go on physicians work in throngs and stress upon preventive medicines to avoid hospital care . In to gain an upper hand over tralatitious insurance plans majority of HMO s call for their patients to select a primary care physician (PCP ) such as internists pediatricians , family doctors or general practitioners to act as gatekeeper to health harmonise . then in a typical HMO instrument a patient first visits a PCP and if unavoidable the PCP refers and authorizes the patient to visit a specialiser or other doctors .

In emergencies a patient whitethorn allow outright approach the specialist without an authorization from PCP around of the plans go for chronically ill patients to select a specialist of their alternative as PCP and women to select a gynaecologist / accoucheur in addition to a PCPAccording to Wikipedia HMO s beam out a utilization review and utilization expressed by keeping a count of number of visits or services or amount spent per member per month (PMPMHMO s may operate in one or a conflate of two or more forms . Some of the models are explained as underStaff Model : Physicians are employed and paid by the HMO s and operate from the office premises of HMO buildings , consequently the physicians may run across only the HMO patients . This is an pillowcase of closed circuit card HMOGroup Model : This is another fount of closed panel model wherein the HMO pays to a group of physicians and the group in pass on allocates and distributes the money amongst themIn have panel HMO , an Independent physical exercise tie-up (IPA ) consisting of commenceed 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 , any faction of groups or even individual physiciansAccording to interbreeding Henricks benefits included limitless visits to primary care doctors , no supernumerary charges are levied for laboratory and radiology services rendered , Most HMO...If you involve to get a full essay, order it on our website: OrderEssay.net

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