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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 ...
HMO schemes have been subsequently introduced to other parts of the UK, though the legal definition of what constitutes an HMO varies between Scotland, Northern Ireland, England, and Wales. Generally, in the United Kingdom, an HMO has the following characteristics: at least three tenants live there, forming more than one household and
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).
An HMO Point-of-Service (HMO-POS) plan is a type of HMO plan. With an HMO-POS plan, an individual must choose a PCP, but they can use out-of-network services at a higher cost, similar to a PPO plan.
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 term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques").
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 ...
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 ...