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Capitation is a payment arrangement for health care service providers. It pays a set amount for each enrolled person assigned to them, per period of time, whether or not that person seeks care. It pays a set amount for each enrolled person assigned to them, per period of time, whether or not that person seeks care.
An HMO may also contract with an existing, independent group practice ("independent group model"), which will generally continue to treat non-HMO patients. Group model HMOs are also considered closed-panel, because doctors must be part of the group practice to participate in the HMO - the HMO panel is closed to other physicians in the community.
As defined in the act, a federally-qualified HMO would, in exchange for a subscriber fee (premium), allow members access to a panel of employed physicians or a network of doctors and facilities including hospitals. In return, the HMO received mandated market access and could receive federal development funds.
HMO. Health Maintenance Organization plans are often considered the most affordable insurance option. With low deductibles and low copays for doctor visits and pharmaceuticals, HMOs are affordable ...
A health savings account (HSA) and a health maintenance organization (HMO) are both intended to help people cover the costs of medical care. However, they take very different approaches.
Like an HMO, an ACO is "an entity that will be 'held accountable' for providing comprehensive health services to a population." [ 3 ] The model builds on the Medicare Physician Group [ 4 ] [ 5 ] Practice Demonstration and the Medicare Health Care Quality Demonstration, [ 6 ] [ 7 ] established by the 2003 Medicare Prescription Drug, Improvement ...