The Healthcare Industry of America; An investigative look at HMOs Essa

The Healthcare Industry of America An inquiring aroma at health maintenance organizations Its no secret that Health Maintenance Organizations, known as health maintenance organizations, have made healthcare affordable for more Americans, but at what risks? Most employers offer some type of health care mean that is an HMO. Lets face it, given the choice among restitution reportage through your employer, in which he pays half the costs, or acquiring private insurance policy reportage outside your employer, most Americans choose to go with employer-provided HMOs. Why then, has there been so much controversy with HMOs? An HMO is an organization whereby the subscriber, or affected role, is granted to choose a medical provider from a list of doctors within a trustworthy medical group. Each physician has signed a contract to put one over endurings at a reduced rate. This type of political program does not render the affected role freedom to decide just any doctor. All referra ls to a doctor, other than the endurings primary care physician, must be approved by both that physician, and the insurance company. Most physicians add HMOs as a tack on to their practices. With HMOs, the patient has little or no co-payment depending on how the plan is effectuate up. Most HMO co-payments range mingled with $5 to $15 dollars per powerfulness visit. The doctor, may receive half or less than half of his average fee from the insurance companies. HMOs are characterized with the tendency to over or nether treat patients. HMOs put limitations not only on the income of the provider, but in like manner on the type of treatment that may be done. If a patient is in need of a specialist for a specific ailment, the insurance company has to review and approve a referral and deem it necessary. The process involves the patient going to his or her general practitioner, overly re... ...he pros. It helps immensely if you have the keep of your primary care physician. If you have a hearing, find out how legion(predicate) people will be there and make up a folder for each one.a). Contact local lawmakers, senators, representatives.b). Contact your State damages Commission in writing about your complaint. Send copies of correspondence mingled with you and your HMO. Let the HMO know you are contacting your State insurance Commission. kit and boodle Cited Evans, M. Stanton. If youre in an HMO, heres why. Consumers Research Magazine, Dec. 1997 p10(6). Sherrid, Pamela. Mismanaged Care. U.S. News & World Report, Nov. 24, 1997 p57(3). Lowenberg, Stanley C. Hard Path to HMO reform. Los Angeles Times, Feb. 2, 1998 pB(4) col. 1. Figueroa, Liz. State Regulations of Healthcare Reform. Los Angeles Times, March 4, 1998 pB(6) col. 4. The Healthcare Industry of America An investigative carriage at HMOs EssaThe Healthcare Industry of America An investigative look at HMOs Its no secret that Health Maintenance Organizations, known as HMOs, have made he althcare affordable for many Americans, but at what risks? Most employers offer some type of health care plan that is an HMO. Lets face it, given the choice among insurance coverage through your employer, in which he pays half the costs, or acquiring private insurance coverage outside your employer, most Americans choose to go with employer-provided HMOs. Why then, has there been so much controversy with HMOs? An HMO is an organization whereby the subscriber, or patient, is allowed to choose a medical provider from a list of doctors within a certain(p) medical group. Each physician has signed a contract to see patients at a reduced rate. This type of plan does not allow the patient freedom to see just any doctor. All referrals to a doctor, other than the patients primary care physician, must be approved by both that physician, and the insurance company. Most physicians add HMOs as a adjunct to their practices. With HMOs, the patient has little or no co-payment depending on how the plan is solidifying up. Most HMO co-payments range between $5 to $15 dollars per smudge visit. The doctor, may receive half or less than half of his familiar fee from the insurance companies. HMOs are characterized with the tendency to over or below treat patients. HMOs put limitations not only on the income of the provider, but also on the type of treatment that may be done. If a patient is in need of a specialist for a specific ailment, the insurance company has to review and approve a referral and deem it necessary. The process involves the patient going to his or her general practitioner, also re... ...he pros. It helps immensely if you have the gestate of your primary care physician. If you have a hearing, find out how many people will be there and make up a folder for each one.a). Contact local lawmakers, senators, representatives.b). Contact your State Insurance Commission in writing about your complaint. Send copies of correspondence between you and your HMO. Let the H MO know you are contacting your State Insurance Commission. whole works Cited Evans, M. Stanton. If youre in an HMO, heres why. Consumers Research Magazine, Dec. 1997 p10(6). Sherrid, Pamela. Mismanaged Care. U.S. News & World Report, Nov. 24, 1997 p57(3). Lowenberg, Stanley C. Hard Path to HMO reform. Los Angeles Times, Feb. 2, 1998 pB(4) col. 1. Figueroa, Liz. State Regulations of Healthcare Reform. Los Angeles Times, March 4, 1998 pB(6) col. 4.