Health Maintenance Organization

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Related to Health Maintenance Organizations: Preferred provider organizations

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.
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References in periodicals archive ?
HMO: or health maintenance organization, is a medical insurance and health care plan that offers a specific list of doctors and hospitals from whom members must receive their care.
Managed-care companies such as health maintenance organizations and preferred provider organizations must select and retain qualified physicians who will provide quality services to their sub scribers, according to Margolis & Co.
Health maintenance organizations have come under sharp attack in New York.
What's required is a network of Preventive Health Maintenance Organizations (PHMO) to provide prepaid care for a wide range of alternative or simply relaxing treatments.
Second, there is a fear that while select black physicians will be "gobbled" up by multi-physician health maintenance organizations (HMOs), those that do not want to or are not asked to join such groups will lose their practices.
Over the past few years, third-party payers, such as large employer-based benefit plans, health maintenance organizations and traditional insurers, have increasingly found a new profit source--recoveries from prescription-drug overcharge litigation.
TO LOWER COSTS, MEDICARE AND MEDICAID ARE encouraging their beneficiaries to enroll in health maintenance organizations (HMOs).
The trillion-dollar health care industry, now nearly one-sixth of the nation's economy, is in "portentous turbulence," with doctors, hospitals, health maintenance organizations (HMOs), insurance carriers, and pharmaceutical companies reshaping health care, scrambling into mergers and networks, cooking up new delivery systems, and mounting aggressive marketing campaigns.
In effect, group health maintenance organizations became free of personal income tax.
Hospitals and academic health centers create group practices of physicians and physician-hospital organizations and start, or acquire, health maintenance organizations. Multispecialty group practices that own hospitals add satellite clinics in distant communities, start health plans, and ally with other hospitals from which they want to obtain patients on referral.
* The Federal HMO Act of 1973 sought to foster the creation of health maintenance organizations.
Monitoring will enable them to remain in the market as viable AHPs, or compete with other groups to subcontract with health maintenance organizations (HMOs) or management service only (MSO) groups.

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