Health Maintenance Organization


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Related to Health Maintenance Organization: preferred provider organization, Health Maintenance Organization Act of 1973

Health Maintenance Organization

Commonly called an HMO. A nonprofit organization that offers health insurance to a group of persons and charges members of the group the same monthly premium. Most HMOs require policyholders to have a primary physician who provides referrals for specialists and other medical services. Without these referrals, medical care generally will not be covered. This fact has made HMOs somewhat controversial. However, they generally operate at a lower out-of-pocket cost to consumers. They trace their origins to the early 20th century, but became more popular after the Health Maintenance Organization Act of 1973.
References in periodicals archive ?
At least six states have outlawed gag rules under which some health maintenance organizations threaten to dismiss doctors if they inform patients about alternative care that might add to costs.
As increasing numbers of health maintenance organizations look at cost-cutting measures to put their companies back in the black, many are considering or implementing premium hikes.
The operating subsidiaries, including health maintenance organizations, are well capitalized and maintain good dividend capacity.
The National Committee on Quality Assurance's Quality Compass shows a wide disparity among health maintenance organizations and other managed care plans on a variety of quality measures.
But the governors point out that the programs are intertwined, so that when the federal government cuts Medicare payments to hospitals and health maintenance organizations or increases premiums for Medicare beneficiaries, states incur new costs.
But some health maintenance organizations have adopted guidelines encouraging doctors to discharge mastectomy patients without overnight stays, and some experts estimate 7 percent or 8 percent of such procedures are now done on an outpatient basis.
The doctors group voted to push for legislation requiring doctors, if their speech to patients is curtailed by clauses in their agreements with health maintenance organizations, to tell patients that such clauses exist.
HPI currently furnishes pharmacy management services to more than 200 hospitals, long-term care facilities and Health Maintenance Organizations nationwide, including the 23 facilities operated by the Department of Mental Health, Mental Retardation and Public Health for the Commonwealth of Massachusetts.
While some analysts expect the health maintenance organizations to improve later in the year, as they did last year after a weak first half, others say they are in a down cycle that may continue into 1997.
The American Association of Retired Persons announced recently that it plans to endorse health maintenance organizations (HMOs) that meet its standards for quality health care, cost and member satisfaction.
In a move that could prompt millions of older Americans to join managed health plans, the American Association of Retired Persons will begin licensing its name to health maintenance organizations across the country later this year.
15 /PRNewswire/ -- The nation's health maintenance organizations have been called on by the Clinton administration to take a lead role in the Childhood Immunization Initiative, according to Group Health Association of America (GHAA).

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