HMO In Medicare: A Case Study

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The capitation rates for HMO in Medicare consist of the number of individuals who enroll in HMO plans. It would be in the best interest of providers to provide superb care, so they do not run the risk of losing consumers to other plans. However, the more customers enrolling in an HMO increases the number medical procedures and testing which will increase the cost of providing treatment. A high number of HMO members will decrease the profits of physicians. According to Hicks (2014), By limiting the services for current patients, unenrolling high-risk patients and seeking out those with lower risk factors will reduce the cost of treatment. United Healthcare Medicare Advantage plans offer an HMO options with set rates that reimburse the providers

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