What is the goal of the HMO?

Asked by: Neva Lakin  |  Last update: February 11, 2022
Score: 4.9/5 (13 votes)

HMOs are a type of managed care designed to maintain the health of their patients cost-effectively. A primary method HMOs use to achieve these goals is to coordinate health services and care provided to patients.

What is the goal of the HMO quizlet?

(6) Preventative Care Services - Main goal of the HMO Act was to reduce the cost of health care by utilizing preventive care. HMOs offer free annual check-ups for the entire family. Also, HMOs offer free or low-cost immunizations to members in an effort to prevent certain diseases.

What is the purpose of HMO?

The purpose of a Health Maintenance Organization is to focus on overall patient wellness and preventive healthcare while keeping costs low for its members by only covering in-network physicians and facilities.

What was the purpose of the Health Maintenance Organization Act of 1973 did it achieve its intended goal Why or why not?

What was the purpose of the Health Maintenance Organization Act of 1973? Did it achieve its intended goal? Its purpose was to provide insurance companies funds to start using HMOs with the idea that it would stimulate competition for enrollees therefore reducing costs.

What were the main features of the HMO Act?

It provided grants and loans to provide, start, or expand a Health Maintenance Organization (HMO); removed certain state restrictions for federally qualified HMOs; and required employers with 25 or more employees to offer federally certified HMO options IF they offered traditional health insurance to employees.

HMO Rules, Regulations and Legislation!

17 related questions found

What is the main feature of the HMO Act of 1973?

The HMO Act of 1973 authorized $375 million over a five-year period to encourage development of HMOs, through direct financial assistance in the form of grants and contracts, loans and loan guarantees.

What does HMO stand for quizlet?

Health Maintenance Organization (HMO) Flashcards | Quizlet. Explanations.

What do the initials HMO stand for quizlet?

HMO ( health maintenance organization)

What is PPO good for?

A PPO is generally a good option if you want more control over your choices and don't mind paying more for that ability. It would be especially helpful if you travel a lot, since you would not need to see a primary care physician.

Are HMO plans good?

The advantages of HMO plans compared with PPO plans make them a popular choice if you're budget-conscious or if you don't anticipate many doctor visits. Lower monthly premiums and generally lower out-of-pocket costs. Generally lower out-of-pocket costs for prescriptions.

What are the pros and cons of an HMO?

HMO Pros and Cons
  • Usually cheaper than the same coverage using Original Medicare.
  • Privately run companies.
  • Billing is often more streamlined and easier to understand.
  • Many plans to choose from so you can get the best plan for your needs.
  • Often includes some coverage not covered under Original Medicare.

What is better HMO and PPO?

HMO plans typically have lower monthly premiums. You can also expect to pay less out of pocket. PPOs tend to have higher monthly premiums in exchange for the flexibility to use providers both in and out of network without a referral. Out-of-pocket medical costs can also run higher with a PPO plan.

Why do HMOs encourage healthy lifestyle practices?

Why do HMOs encourage their clients to practice healthy lifestyles? Because it is cheaper to prevent an illness than to treat an illness. ... People who cannot afford health care services are more likely to become sick than those who can afford health care services.

What is the principle behind managed care?

What is the principle of managed care? Managed care was developed as a response to rising health care cost. The Principle behind managed care is that all health care provided to a patient must have a purpose. ... Fee stays the same regardless of amount of health care use.

What are the two traits required of health care professionals?

Honesty and integrity are two traits required of the ambulatory health-care professional.

What is a preferred provider plan?

A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan's network.

What is an advantage of PPO over an HMO quizlet?

Preferred Provider Organization (PPO): With a PPO, you may have: 1) A moderate amount of freedom to choose your health care providers-- more than an HMO; you do not have to get a referral from a primary care doctor to see a specialist. 2) Higher out-of-pocket costs if you see out-of-network doctors vs.

When PPO insured goes out-of-network?

PPO plans include out-of-network benefits. They help pay for care you get from providers who don't take your plan. But you usually pay more of the cost. For example, your plan may pay 80 percent and you pay 20 percent if you go to an in-network doctor.

What was the main purpose of the Health Maintenance Organization Act of 1973 quizlet?

The Health Maintenance Organization Act of 1973 was designed to provide an alternative to the traditional fee-for-service practice of medicine. It was aimed at stimulating the growth of HMOs by providing federal funds to establish new HMOs.

Who invented the HMO?

In 1970, the number of HMOs declined to fewer than 40. Paul M. Ellwood Jr., often called the "father" of the HMO, began having discussions with what is today the U.S. Department of Health and Human Services that led to the enactment of the Health Maintenance Organization Act of 1973.

When were HMO plans created?

The Health Maintenance Organization Act, also known as the HMO Act, is a U.S. federal law enacted under President Richard Nixon on December 29th, 1973. The act is stated in bill S. 14 of Public Law 93-222 and defines qualifications for HMOs.

What is the reason for using the systems theory?

What is the reason for using systems theory to study a healthcare facility? It helps the facility to focus on its mission. What is the main type of healthcare system in the United States? Which of the following is true about organizational structures in healthcare facilities?

What is one advantage of individual insurance over group insurance?

With a group health insurance plan, you may provide your employees with quality health insurance benefits that they may not be able to afford themselves. With individual coverage, you are leaving your employees to get coverage for themselves in compliance with the Affordable Care Act.

What is the term given to total good health?

Wellness is total good health. It not only involves treating health problems, but also maintaining one's health. In other words, wellness includes the prevention of health problems. ... Wellness is also referred to as holistic health. Holistic health is the health of the whole person.

Is Blue Shield an HMO?

Blue Shield offers a variety of HMO and PPO plans. Contact us if you have any questions or to find out more about our plans.