Types Of Health Maintenance Organization Plans

HMO- Is the most popular of the plans and is a group of providers that provides services to subscribers with a very small or even co copay when services are rendered. There actually are various types of HMO's that link providers to create a healthcare delivery system, they are Group Model HMO, Individual Practice Association HMO, Network Model HMO, Staff Model HMO, and Open Access HMO.

Patients could be attracted to Staff Model HMOs for a variety of reasons as well; because Staff Model HMOs are practiced in comprehensive medical facilities, all necessary resources are located in one place. Unlike the Group Model, new physicians would be salaried and would therefore not feel the pressure to “push,” patients

Another type of managed care program that was introduced is the Preferred Provider Organization (PPO). A PPO is comprised of a group of physicians, hospitals and other medical service providers who contract with employers, insurance companies or other plan sponsors. The PPO offers discounted pricing to these contracted organizations due to the high volume of business received. PPO’s typically have up-front cost sharing in the form of deductibles and/or co-insurance, which vary depending upon the actual plan chosen.

New England Health Maintenance Organization (HMO) is a regional not for profit managed care company that has its headquarters in Boston, MA, with over 500,000 enrollees within 25 different plans including Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont. A consortium of employers has shown interest in bidding on a managed care contract to be offered to the consortium’s 75,000 employees whom are locate in and around Nashua, New Hampshire. The consortium of employers includes companies such as IBM, Ford, and Prudential Insurance.

Through the use of managed care, HMOs and PPOs are able to reduce the costs of hospitals and physicians. Managed care is a set of incentives and disincentives for physicians to limit what the HMOs and PPOs consider

An HMO is an organization whereby the subscriber, or patient, is allowed to choose a medical provider from a list of doctors within a certain medical group. Each physician

HMOs are usually the least expensive health plans, offer predictable costs for health care, the least administrative paperwork, and cover preventive care (Barsukiewicz, Raffel, & Raffel, 2010). However, HMOs also restrict direct access to specialists by requiring referrals by a PCP, requiring patients to see a provider in the HMO network, and often not covering more costly procedures or care options, because care is managed to control excessive or unnecessary care. Providers gain if they provide less care (Austin & Wetle, 2012). This incentive could affect patient-provider trust.

The relationship of an HMO and its physician member is to help provide a wider range health care for its patients and a wide area of services available for its physician members. A patient must choose a primary care physician from a list of providers. The relationship with the physician provided from the HMO is in a contract that is to deliver services to their patients for a fee. There can also be a group plan which is a HMOs contract with a group of physicians to deliver services. The HMO organization compared to PPOs, a PPO is a variation of an HMO, and it features traditional insurance and managed care.

In spite of the Native Americans, Bison were hunted near extinction in the 19th century. Stats show that bison population decreases in the late 1880s. They were hunted for fur, with the rest of the animal left behind to decay in the ground. After they rotted their bones were found packaged and shipped East. Main purpose the U.S. military hunted buffalo was to deprive Native Americans of food because that was what they lived off of, also to clear the great plains and make space for railroads. In 2005 hunting buffalo became illegal, U.S. Senate offered each states American tribes two hunters license each however if citizens are caught hunting Bison a reduced fee will be paid. Female buffalo are around five feet tall and weigh between 800-1000

(POS). There are over half of Americans with health insurance are enrolled in managed care

Managed Care from a consumer’s perspective is more affordable, there is no deductible and there is also no obligation to pay a percentage of the medical bill. Therefore the difference between the two, Traditional and Managed is simply financial. From a physician’s stand of point traditional insurance (fee-for-service), the consumer or patient pays the physician directly unless the patient has exceeded their deductible from their insurance, in which case the patient would pay a portion of the bill, and the remaining balance is reimbursed from the insurance to the physician. Being a physician who participates in Managed Care accepting various medical insurance like HMO, PPO the physician is provided with several amenities which include an office and administrated support, salary, better working hours. With PPO some of the amenities may include treating patients outside the plan, stable patient load, and independence to run office.

The types of managed care are differentiated by definition, operation, structure, and information needs. `HMOs were the most common type of MCO until commercial insurance companies developed PPOs to compete with HMOs' (Douglas, 2003, p.331). `HMOs are business entities that either arrange for or provide health services to an enrolled population after prepayment of a fixed sum of money, called a premium' (Peden, 1998, p.78). There are three characteristics that an HMO must have. The first is a health care financing and delivery system that provides services for members in a particular geographic area. Second, is ensured access to a complete range of health care services, health maintenance, treatment, and routine checkups. Last, health care must be obtained from voluntary personnel that participate in the HMO. The five HMO models related to the participating physicians are the Staff

Throughout the last half of the 20th century, employers have acted on their own to regulate health costs by requiring employees to join health maintenance organizations (HMOs). More than 100 million Americans are under managed care. However, many patients and doctors complain that HMOs impose too many regulations and sacrifice healthcare quality. HMOs are undergoing a high level of scrutiny due to criticisms that the network is controlling and jeopardizing the healthcare system of the nation.

Il Pantheon (Pantheon) “pan” means all, “theon” means God. It is a preserved intact Roman Empire building, located in the centre of Rome, Italy. It was built in 27-25 BC by Marcus Agrippa, and Emperor Hadrian rebuilt it in 125 AD.

Despite it’s long history of coal, oil, and gas development, Pennsylvania has seemingly been overcome by the rapidity and scale of production demonstrated with the recent boom of Marcellus Shale industry, which has companies, workers, environmentalists, etc. flocking to its northern tier. However, controversy seems to have followed as “the economic criticism of the drilling industry is that it booms and then busts, generating few local jobs and leaving little lasting economic benefit” (Schwartz). Thus making it critically important not only the economic impact, but also those of social, institutional and environmental now and in the years to come” (“Marcellus Shale”).