Health Maintenance Organization : South University

1010 WordsApr 8, 20175 Pages
Assignment 3: Health Maintenance Organization South University Nikki Washington Dr. Perkins April 8, 2017 Health Maintenance Organization When breaking down various HMO models that is being evaluated for the region, the HMO that would be best suited for the hospital in the small rural community that would have critical care access would be the staff group model. The staff group would be ideal however in some cases patients would need referrals to gain access to the specialty providers that they may need after being released from the hospital, but during a hospital visit the providers should already be available to patients. A potential down side to getting a referral is patients could have a longer wait time for appointments and…show more content…
This will allow patients’ access to providers within the network and could possibly penalize any patient that goes outside the network. Contracting the network groups also continues to keep money within the communities and also provide incentives for groups to join the network. The American Trauma Society has (five) levels of trauma care. The importance and applicability of the various levels of emergency department trauma care are imperative to helping the community and providing affordable health care to people with little to no income. Each level of trauma care is vital in various communities to ensure the appropriate trauma level is made available based on the communities’ population. According to American Trauma Society (2017), Level I trauma center is a comprehensive regional resource that is a tertiary care facility central to the trauma system. It is capable of providing total care for every aspect of injury from prevention through rehabilitation. Level I include 24 hour coverage by general surgeons and specialty care physicians. Level II also includes 24 hour coverage but limited on specialty physicians but does include tertiary that are referred in Level I. Level III also offer some of the same levels of care that I and II offers but Level III through V are limited and basically stabilize patients before transferring them to a higher level trauma center. It is vital and very important that the hospital’s trauma level matches the community’s needs. It
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