This type of closed-panel HMO generally is made up of one or more physician group practices that are not owned by the HMO but operate as independent partnerships or professional corporations. Instead of employing the doctors and paying them salaries, the HMO contracts with the group practice to provide or arrange covered services for each HMO member who is a patient of the group.
Health care plan involving contracts with physicians organized as a partnership, professional corporation, or other legal association. It can also refer to an HMO model in which the HMO contracts with one or more medical groups to provide services to members. In either case, the payer or health plan pays the medical group, which is, in turn, is responsible for compensating physicians. The medical group may also be responsible for paying or contracting with hospitals and other providers.
An HMO that contracts with a multispecialty medical group to provide care for HMO members; members are required to receive medical care from a physician within the group unless a referral is made outside the network.
An HMO where the doctors work at a central site. See Independent Practice Association, Network Model HMO, Staff Model HMO.
Health Maintenance Organization that contracts with a multi-specialty group of physicians who are employees of the group practice. Also known as a group practice model HMO.
A health care model involving contracts with physicians organized as a partnership, professional corporation, or other association. The health plan compensates the medical group for contracted services at a negotiated rate, and that group is responsible for compensating its physicians and contracting with hospitals for care of their patients.
An HMO which contracts for services of treatment professionals in an existing group practice, usually with financial incentives for treatment efficiency.
A type of HMO medical center where many different services are provided in unified medical center locations.
An HMO that contracts with a group practice of physicians to provide services to enrollees. These contracts can be either exclusive (the group can only treat plan members), or non-exclusive (the practices are free to contract with other plans and see fee-for-service patients). The latter are often referred to as Network models.
In most group model HMOs, the HMO contracts with physician groups to provide services to the members of the HMO. Under this system the physicians are not employees of the HMO. The physician groups are typically paid using the capitation system. The groups are typically owned by the doctors in the group. The doctors in the groups usually have control over how the services of the HMOs members are provided, and have in control over referrals within the group.
A health plan where a group of physicians is reimbursed for services they provide at a negotiated rate. The HMO also contracts with hospitals for the care of the patients of the physicians who belong to the group.
