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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 ...
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).
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 ...
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 ...
Dr. Paul Starr suggests in his analysis of the American healthcare system (i.e., The Social Transformation of American Medicine) that Richard Nixon, advised by the "father of Health Maintenance Organizations", Dr. Paul M. Ellwood Jr., was the first mainstream political leader to take deliberate steps to change American health care from its ...
The Knox-Keene Health Care Service Plan Act of 1975 is a set of Californian laws that regulate Healthcare Service Plans. Under these laws, pharmacy benefit managers with contracts to Health care service plans are required by law to be registered with the Department of Managed Health Care to disclose information. [58] SB 966: Pharmacy benefits
Health systems management ensures that specific outcomes are attained, that departments within a health facility are running smoothly, that the right people are in the right jobs, that people know what is expected of them, that resources are used efficiently and that all departments are working towards a common goal.
The Healthcare Information and Management Systems Society (HIMSS) is an American not-for-profit organization dedicated to improving health care in quality, safety, cost-effectiveness and access through the best use of information technology and management systems. It was founded in 1961 as the Hospital Management Systems Society.