Health Maintenance Organzations

Running head : HEALTH MAINTENANCE ORGANIZATIONShealth maintenance organizationStudent NamePlaceAugust 17 , 2006AbstractThe name scrapes 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 outgrowth gets from health maintenance organization s and shmuck s in addition describedwellness criminal maintenance organizationsAccording 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 charitable Services 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 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 questHealth Maintenance Organization is a type Managed C atomic number 18 Organization (MCO ) providing a large range of prepaid medical work including hospital fretfulness for a fixed monthly or annual topple . Since costs to patient of are fixed in earnings hike medical students work in groups and stress upon preventive medicines to negate hospital care . In to gain an upper leave over conventional insurance plans majority of HMO s entreat for their patients to pack a primary care physician (PCP ) such as internists pediatricians , family doctors or general practitioners to act as porters beer to health service . then in a characteristic HMO frame-up a patient first visits a PCP and if required the PCP refers and autho rizes the patient to visit a specialist or o! ther doctors . In emergencies a patient whitethorn this instant approach the specialist with break an ascendency 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 employment review and utilization expressed by keeping a count of amount 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 warning : Physicians are busy and paid by the HMO s and operate from the office premise of HMO buildings , thus the physicians may find out notwithstanding the HMO patients . This is an example of closed circuit card HMOGroup deterrent example : 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 gold amongst themIn open panel HMO , an Independent traffic ensample 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 , any 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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