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The Health Maintenance Organization Act of 1973 (Pub. L. 93-222 codified as 42 U.S.C. §300e) is a United States statute enacted on December 29, 1973. The Health Maintenance Organization Act, informally known as the federal HMO Act, is a federal law that provides for a trial federal program to promote and encourage the development of health maintenance organizations (HMOs).
In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. [1] It is an organization that provides or arranges managed care for health insurance , self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care ...
Managed care plans and strategies proliferated and quickly became nearly ubiquitous in the U.S. However, this rapid growth led to a consumer backlash. Because many managed care health plans are provided by for-profit companies, their cost-control efforts are driven by the need to generate profits and not providing health care. [5]
PPO. The Preferred Provider Organization plan is the most popular for those with employment-based insurance (currently 47% of them, in fact). PPOs allow the most flexibility in that people can ...
Healthcare coverage is provided through a combination of private health insurance and public health coverage (e.g., Medicare, Medicaid). In 2013, 64% of health spending was paid for by the government, [40] [41] and funded via programs such as Medicare, Medicaid, the Children's Health Insurance Program, Tricare, and the Veterans Health ...
NCQA's web site includes a summary of HEDIS results by health plan. NCQA also collaborates annually with U.S. News & World Report to rank HMOs using an index that combines many HEDIS measures and accreditation status. The "Best Health Plans" list is published in the magazine in October and is available on the magazine's web site.
"Effects of Cost Sharing on Use of Medical Services and Health" (PDF). Medical Practice Management. 8: 317– 321. – summarizes major findings of the RAND Health Insurance Experiment; Normand, C (June 25, 1994). "Views and reviews – Free for All: Lessons from the RAND Health Insurance Experiment". The BMJ. 308. BMJ Publishing Group Ltd: 1724.
In February 1974, Nixon proposed more comprehensive health insurance reform—an employer mandate to offer private health insurance if employees volunteered to pay 25 percent of premiums, replacement of Medicaid by state-run health insurance plans available to all with income-based premiums and cost sharing, and replacement of Medicare with a ...