Health Maintenance Organization Model

Superior Essays
Various HMO models (Staff, Group, & Network)
Health Maintenance Organizations (HMO) have been around since the 20th century. They were not made to operate as they do currently in today’s world until the Health Maintenance Organization Act of 1973 set federal rules on how the operations of HMO should be conducted. HMO’s have various models, but despite the model, in each HMO, the employer pays the monthly premium for the HMO service, which reduces the overhead for employees seeking medical help. This is only the case as long as the medical help received is from a doctor or physician within the HMO. The different models of HMO’s consist of staff model, group model, and network model.
Staff model of an HMO is “the physicians and medical professionals
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With this model the HMO “…contracts with multi-specialty medical group practice and provide all physician services to the HMO’s members. The physicians in the group are employed by the group practice and not by the HMO” (Kongstvedt, 2013). The physicians in the group model HMO also share facilities, equipment, medical records and support staff. The HMO is in charge of paying the group in bulk, and the physicians are in charge of deciding how the funds are distributed.
The other type of HMO model is the network model. This model also contains some of the characteristics of the group model. This type of HMO sets contracts with a “…combination of multi-specialty physician group practices, independent practice associations and fully independent physicians to provide medical services” (Kongstvedt, 2013). This model is currently one of the more popular and/or preferred models out all of the HMO choices.
Importance and applicability of the various levels of emergency department trauma
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Physicians many times believed they knew what their patients needs and that they have the answers to what good patient care is for the patient. Patient- centered care though “is an understanding that patients must be asked to rate or judge their health care…” (Rickert, 2012). To put it in simple terms, patient centered care is a transition from doctors asking what’s wrong to asking what matters to the patients. The other part to patient centered care is about the relationship between healthcare providers and their patients. This type of care helps physicians determine what is important to the patient as well as the best preference of care to best help the patient. This is the important to healthcare delivery because it allows the physician to better and more accurately assess patients’ needs and properly administer a treatment or other course of action. By establishing this relationship with the patient through the patient-centered care, the patient and doctor have a more personal connection, thus creating a more trusting relationship between physician and patient. A “…lack of relationship significantly influenced her health decisions in the same way it impacts all patients” (Rickert,

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