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Employers with 25 or more employees were required to offer federally certified HMO options alongside indemnity upon request; This last provision, called the dual choice provision, was the most important, as it gave HMOs access to the critical employer-based market that had often been blocked in the past.
Health Maintenance Organization (HMO) is a term first conceived of by Dr. Paul M. Ellwood, Jr. [4] The concept for the HMO Act began with discussions Ellwood and his Interstudy group members had with Nixon administration advisors [5] who were looking for a way to curb medical inflation. [6] Ellwood's work led to the eventual HMO Act of 1973. [7]
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 ...
The generic model used in the United States is the chronic care model, which holds that health care does not only involve change in the patient and that high-quality disease care counts the community, the health system, self-management support, delivery system design, decision support, and clinical information systems as important elements in ...
As managed care became popular, health care quality became an important aspect. The HMO Act in 1973 included a voluntary program of "federal qualification", which became popular, but over time this role was largely taken over by the National Committee for Quality Assurance (NCQA), which began accrediting plans in 1991.
These programs are widely known as employee assistance programs or EAPs and include various physical and mental health services to employees. Workplace wellness programs have been around since the 1970s [34] and have gained new popularity as the push for cost savings in the health delivery system becomes more evident as a result of high health ...
The terms "open panel" and "closed panel" are sometimes used to describe which health care providers in a community have the opportunity to participate in a plan. In a "closed panel" HMO, the network providers are either HMO employees (staff model) or members of large group practices with which the HMO has a contract.
In 1972, HMSA introduced the Community Health Program, its first Health maintenance organization (HMO). The Hawaii Prepaid Health Care Act of 1974 required nearly all employers to provide health insurance to full-time employees. In 1980, Health Plan Hawaii was certified as a federally qualified HMO. [4]