What was the initial purpose of an HMO?

What is an HMO quizlet?

Health Maintenance Organization (HMO) An organization that provides its members with basic healthcare services for a fixed price and for a given time period.

What does HMO stand for quizlet?

Health Maintenance Organization (HMO) Flashcards | Quizlet.

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

The Health Maintenance Organization (HMO) Act of 1973 provided for a Federal program to develop alternatives to the traditional forms of health care delivery and financing by assisting and encouraging the establishment and expansion of HMOs.

Which of the following is a 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.

Which of the following describes the HMO Act of 1973 quizlet?

The HMO Act of 1973 specified requirements that must be met for an HMO to receive federal qualification. For example, federally qualified HMOs must provide basic health care services and charge a community rate.

What is the primary purpose of a Health Maintenance Organization HMO apex?

A Health Maintenance Organization (HMO) provides a wide range of benefits that cover the entire health care spectrum, from preventive care and education to physician care, surgery and hospitalization.

What is the meaning of HMO?

A health maintenance organization (HMO) is a network or organization that provides health insurance coverage for a monthly or annual fee. An HMO is made up of a group of medical insurance providers that limit coverage to medical care provided through doctors and other providers who are under contract with the HMO.

What was the first HMO?

Sometimes cited as the first example of a health maintenance organization (HMO), the Western Clinic in Tacoma, Washington, began in 1910 to offer, ex- clusively through its own providers, a broad range of medical services in return for a premium payment of $0.50 per member per month.

How did HMOs affect insurance companies?

Since more HMOs reduce the number of health care providers available, the wholesale price paid by nonintegrated insurers to providers increases. This increase in wholesale price increases the nonintegrated insurers' marginal cost and thus their premiums.

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.

Who started the first HMO?

Michael Shadid created a health plan in Elk City, Oklahoma in which farmers bought shares for $50 to raise the money to build a hospital.

When did HMOs become popular?

HMOs were predicted to cover 40 million persons and to be available to 90 percent of the entire U.S. population by the late 1970s (Falkson, 1980).

How do HMOs help prevent future medical problems?

HMOs are believed to achieve most of their savings by reducing hospital use, presumably by substituting less expensive types of care, including ambulatory care, home health visits, and nursing home care, and by practicing preventive care.

When the American medical Association was formed in 1847 its initial purpose was to?

Founding of the AMA

Nathan S. Davis, calling for a national medical convention, led to the establishment of the American Medical Association (AMA) in 1847. Scientific advancement, standards for medical education, launching a program of medical ethics, improved public health — these were the goals of the AMA.

What are the four main models of HMOs?

Health Maintenance Organization: An organization that provides or arranges for coverage of designated health services needed by plan members for a fixed prepaid premium. There are four basic models of HMOs: group model, individual practice association (IPA), network model, and staff model.

How does a Health Maintenance Organization HMO work quizlet?

The HMO contracts with an independent medical group to provide a variety of medical services to subscribers. Under the agreement, the HMO pays a capitation fee to the medical group entity directly. A capitation fee is a fixed amount paid monthly per subscriber.

What is the difference between an HMO and a PPO quizlet?

Terms in this set (10) What is one difference between an HMO and a PPO? HMOs hire care providers, however, PPOs contract other independent providers thus allowing individuals to choose from a list of providers to see. One of the main provisions of the Affordable Care Act was the individual mandate.

What is the primary care provider referred to in a Health Maintenance Organization HMO quizlet?

Choice of physicians is limited to the group of medical service providers who have agreed to provide services for the agreed-upon price and to uphold the standards of the HMO. These are known as primary care physicians. A primary care physician must refer members to health care specialists.

How does a health maintenance organization HMO work?

A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage.

What three characteristics are required for an organization to qualify as an HMO?