decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Health Maintenance Organizations / The 4 Basic HMO Models
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Article Overview
This article explains the basic organizational forms used by health maintenance organizations, including how physician groups, independent practice associations, and integrated plan arrangements are structured. It is relevant for readers who need a general understanding of managed care models, health plan organization, and how care delivery is arranged within HMOs.
Why This Topic Matters
Understanding HMO model structures helps readers interpret managed care terminology and distinguish among common delivery and contracting arrangements used in health plans. The article provides background context for compliance, administration, and health care business operations.
What You Will Learn
- The main organizational models used by HMOs
- How physician services may be arranged within different health plan structures
- How independent practice associations fit into managed care delivery
- How integrated plan and physician arrangements differ from other HMO models
Who Should Read This
- Medical coders
- Billing professionals
- Practice administrators
- Health plan staff
- Compliance professionals
- Students of health care administration
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