• HMOs
  • HMOs cover emergency care regardless of the health care provider's contracted status. (wikipedia.org)
  • HMOs often require members to select a primary care physician (PCP), a doctor who acts as a "gatekeeper" to direct access to medical services but this is not always the case. (wikipedia.org)
  • HMOs often provide preventive care for a lower copayment or for free, in order to keep members from developing a preventable condition that would require a great deal of medical services. (wikipedia.org)
  • When HMOs were coming into existence, indemnity plans often did not cover preventive services, such as immunizations, well-baby checkups, mammograms, or physicals. (wikipedia.org)
  • The Act solidified the term HMO and gave HMOs greater access to the employer-based market. (wikipedia.org)
  • All at the same or lower price than traditional forms of insurance coverage Federal Financial Assistance for developing HMOs-Assisted individual HMOs in obtaining endorsement (referred to as qualification) from the federal government Marketing Support through Dual Choice Mandate-Required employers to offer coverage from at least one federally qualified HMO to all employees (dual choice). (wikipedia.org)
  • Medical malpractice liability can extend to hospitals and even to health maintenance organizations (HMOs). (thefreedictionary.com)
  • In states that disallow the corporate practice of medicine, plaintiffs may not bring medical malpractice claims against HMOs or hospitals based on a physician's treatment because the doctors are not considered employees. (thefreedictionary.com)
  • The formation of the various Blue Cross and Blue Shield plans, as well as the beginning of many HMOs, in the midst of the Great Depression came about not because consumers were demanding insurance against the risk of medical expenses or because nonphysician entrepreneurs were seeking to establish a business, but rather because providers wanted to maintain and enhance patient revenues. (docplayer.net)
  • The following are examples of early HMOs: The Kaiser Foundation Health Plans were started in 1937 by Dr. Sidney Garfield at the request of the Kaiser construction company. (docplayer.net)
  • 1937
  • In 1937, the Home Owner s Loan Corporation organized the Group Health Association (GHA) in Washington, D.C., to reduce the number of mortgage defaults by families who had large medical expenses. (docplayer.net)
  • entities
  • Kaiser Permanente is administered through eight regions, including one parent and six subordinate health plan entities, one hospital entity, and nine separate, affiliated medical groups: In addition to the regional entities, in 1996, the then-twelve Permanente Medical Groups created The Permanente Federation, a separate entity, which focuses on standardizing patient care and performance under one name and system of policies. (wikipedia.org)
  • practice
  • The AMA took this stance in response to the prepaid group practices in existence at the time (although few in number) and to the findings in 1932 of the Committee on the Cost of Medical Care a highly visible private group of leaders from medicine, dentistry, public health, consumers, and so forth that recommended the expansion of group practice as an efficient health care delivery system. (docplayer.net)
  • The AMA s opposition set the tone for continued state and local medical society resistance to prepaid group practice at the state and local medical society levels. (docplayer.net)
  • benefits
  • Although businesses pursued the HMO model for its alleged cost containment benefits, some research indicates that private HMO plans don't achieve any significant cost savings over non-HMO plans. (wikipedia.org)
  • 1949 Supreme Court upholds National Labor Relations Board ruling that employee benefits are subject to collective bargaining. (ebri.org)
  • 1968 Firestone Tire and Rubber Co. begins to self-fund health benefits. (ebri.org)
  • attract
  • After the Blue Cross/Blue Shield plans were developed, however, the traditional insurers noted the community rating practices and realized that they could enter the market and attract the healthier community members with lower rates than the community rates. (thefreedictionary.com)
  • 1929
  • 2 2 CHAPTER 1 THE ORIGINS OF MANAGED HEALTH CARE In 1929, Dr. Michael Shadid established a rural farmers cooperative health plan in Elk City, Oklahoma. (docplayer.net)
  • In 1929, Baylor Hospital in Texas agreed to provide some 1,500 teachers with prepaid care at its hospital, an arrangement that represented the origins of Blue Cross. (docplayer.net)
  • services
  • It is this inclusion of services intended to maintain a member's health that gave the HMO its name. (wikipedia.org)
  • Some services, such as outpatient mental health care, are limited, and more costly forms of care, diagnosis, or treatment may not be covered. (wikipedia.org)
  • One major area within health care law is Medical Malpractice , which is professional misconduct or lack of skill in providing medical treatment or services. (thefreedictionary.com)
  • program
  • The program was available to lumber mill owners and their employees, and it served to ensure a flow of patients and revenues for the clinic. (docplayer.net)
  • individuals
  • By introducing health screening to identify the healthier individuals, and offering lower rates to younger individuals, these companies were able to lure lower-risk populations to their health plans. (thefreedictionary.com)
  • The proportion of non-elderly individuals with employer-sponsored cover fell from 66% in 2000 to 56% in 2010, then stabilized following the passage of the Affordable Care Act. (wikipedia.org)