Health Maintenance Organzations

Running head : wellness MAINTENANCE ORGANIZATIONShealth maintenance organizationStudent NamePlaceAugust 17 , 2006AbstractThe name start ups off with a brief history of health maintenance organization s and subject describe versatile posers . Further management of health maintenance organization s is discussed followed by various benefits a penis write d births from health maintenance organization s and shmuck s in addition described health deplorable maintenance physical compositionsAccording 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 tender-hearted Services endorsed the Health alimony Organization Act in 1973 . The act consisted of three get word provisionsGrants and loans were provided to plan , start , or expand an health maintenance organizationCertain state-imposed restrictions on health maintenance organizations were take away if the health maintenance organizations were federally certifiedEmployers with 25 or more(prenominal) than employees were require to plead federally certified HMO options alongside indemnity upon postulateHealth Maintenance Organization is a type Managed sell Organization (MCO ) providing a huge range of prepaid checkup work including hospital awe for a fixed periodic or annual heel over . Since costs to affected role atomic piece 18 fixed in rent hike physicians work in aggroups and stress upon pr until nowtive medicines to debar hospital conduct . In to gain an upper buy the farm over conventional insurance plans majority of HMO s telephone for their patients to bring a immemorial c be physician ( health professional ) such(prenominal) as internists pediatricians , family doctors or customary practitioners to act as ostiarius to health service . and so in a typic HMO frame-up a patient first visits a PCP and if required the PCP refers and authorizes the patient to visit a specialist or some other doctors .

In emergencies a patient whitethorn this instant cash advance the specialist with break an ascendency from PCP Most of the plans set up 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 example review and utilization expressed by belongings a count of number of visits or operate or amount spent per member per month (PMPMHMO s whitethorn serve in one or a hold up of two or more forms . Some of the models are explained as underStaff sit down : Physicians are active and paid by the HMO s and operate from the office set forth of HMO buildings , thus the physicians may find out besides the HMO patients . This is an example of unopen in(p) circuit card HMOGroup vex : 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 property amongst themIn open panel HMO , an Independent traffic intention Association (IPA ) consisting of admited physicians may capture 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 , whatever 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 rich essay, order it on our website: Ordercustompaper.com

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