What are some of the pros and cons faced by Health Maintenance Organizations HMOs with regulation
|
journal article Show
Law and Contemporary Problems Vol. 35, No. 4, Health Care: Part 2 (Autumn, 1970) , pp. 716-795 (80 pages) Published By: Duke University School of Law https://doi.org/10.2307/1190949 https://www.jstor.org/stable/1190949 Read and download Log in through your school or library Alternate access options For independent researchers Read Online Read 100 articles/month free Subscribe to JPASS Unlimited reading + 10 downloads Read Online (Free) relies on page scans, which are not currently available to screen readers. To access this article, please contact JSTOR User Support. We'll provide a PDF copy for your screen reader.With a personal account, you can read up to 100 articles each month for free. Get StartedAlready have an account? Log in Monthly Plan
Yearly Plan
Journal Information Established in 1933, Law and Contemporary Problems is Duke Law School's oldest journal. During the first 40 years of publication, the quarterly journal was entirely edited and managed by faculty. In the 1970's a student editorial board was added, although the journal continues to enjoy substantial faculty input. Distinctive in format and content, each issue is devoted to papers on a particular topic of contemporary interest. Usually the topics reflect an interdisciplinary perspective with contributions by lawyers, economists, social scientists, scholars in other disciplines, and public officials. The journal occasionally publishes student notes related to past symposia. Subscribers include general university libraries, government agencies, and foreign educational institutions, as well as the more traditional law libraries and law firms. Law and Contemporary Problems is monitored by a general editor and a faculty advisory committee. Publisher Information Duke Law School was established as a graduate and professional school in 1930. Its mission is to prepare students for responsible and productive lives in the legal profession. As a community of scholars, the Law School also provides leadership at the national and international levels in efforts to improve the law and legal institutions through teaching, research, and other forms of public service. Although Duke University is young by comparison to other major American universities, its academic programs and professional schools together have attained an international stature and a reputation for quality and innovation that few universities can match. Among the Law School's unique strengths are an extensive network of interdisciplinary collaboration across the Duke campus and an emphasis in teaching and research initiatives addressing global and international issues. Rights & Usage This item is part of a JSTOR Collection. A Health Maintenance Organization (HMO) provides a wide range of benefits that cover the entire health care spectrum, from preventive care and education to physician care, surgery and hospitalization. Health care is typically managed by primary care physicians, specialists, hospitals and labs inside the provider network, with premiums and co-payment for certain services or prescriptions. Since contracting discounts from a network of providers is one of the primary ways an HMO maintains cost effectiveness, treatment received outside the network is usually not covered. While an HMO is more restrictive than other plans, doctor visits and health care can be simple, easy and reliable. If there is a need to see a specialist, the doctor will recommend appropriate resources and often make the scheduled appointment on the patient’s behalf.1
1Individual Health Plans, “Health Maintenance Organizations” http://www.individual-health-plans.com/hmoplan.htm 2U.S. Insurance Online, “HMOs” http://www.usinsuranceonline.com/health-insurance/plans/hmo.php What are the advantages and disadvantages of health maintenance organizations HMOs?The HMO charges a fixed monthly fee so its members can receive health care. There will be a small co-payment for each doctor visit; however with the HMO, fees can be forecasted unlike a fee-for-service insurance plan. Although freedom of choice is given up, out-of-pocket expenses are very low.
What are negatives about HMOs?Disadvantages of HMO plans
HMO plans require you to stay within their network for care, unless it's a medical emergency. If your current doctor isn't part of the HMO's network, you'll need to choose a new primary care doctor.
What is a health maintenance organization or HMO quizlet?Health Maintenance Organization (HMO) An organization that provides its members with basic healthcare services for a fixed price and for a given time period.
Which of the following regulates the quality of care provided by a health maintenance organization?The US Health Care Financing Administration (HCFA) regulates HMOs and has instituted guidelines for reporting and quality assessment in an accreditation approach to quality assurance (see Chapter 15).
|
