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System Evolution

In: Computers and Technology

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System Evolution
Celia A Langlinais
HCI/500
Week 3
05/14/2012

Systems Evolution

Health Management Organizations (HMO) is a prepaid health care coverage. In an HMO health care coverage plan, the patient picks primary care physicians (PCP) who takes complete care of the patients’ medical needs. This PCP has a contract with HMO and has to follow HMO regulations. In some cases, which the PCP is not qualified to treat a specific medical problem, so the patient is referred to a specialist. This type of coverage was started in Two Harbors, Minnesota. A railroad company had two doctors who retired and left them without any health care service. This prompted the community to buy the hospital from the railroad and create the Community Health Association in 1944. This became the model for today’s HMOs but this is not the first of its kind. In the history of health care there have been programs similar to the HMO coverage, which helped mold the HMOs of today. The first example of an HMO was seen in 1910 in Tacoma, Washington. A timber mill and their employees paid a premium each month for certain medical services. In 1929 Ross-Loos Medical Group offered medical services to the Los Angeles Department of Water and Power and Los Angeles employees for a premium every month. This prompted the fire and police departments to enroll within the year. In 1982 as Ross-Loos Medical Group continued to grow, they merged with the Insurance Company of North America and Connecticut General to form CIGNA Health Care (Wikipedia, the free encyclopedia, 2011). In the early 1960s Dr. Paul M. Ellwood formulated the prepaid health care plans in which doctors and professional staff operate and administer the health care services in conjunction with HMO. Then in 1972 Dr. Ellwood initiated the pilot program to test his concept.
This pilot started the push for the Health Management Organizations Act passed by the Minnesota Legislature in 1973. With this act in place people could get health care they needed for a prepaid price, did not matter what type of care or how often the patient saw the doctor. HMO is a “non-profit organization, providing comprehensive health maintenance services in exchange for a fixed prepaid sum, regardless of frequency or extent of care required” (Minnesota Historical Society, n.d.) The Health Management Organizations Act of 1973 required three provisions. One provision for the HMO to start or expand, it had to use grants or loans to do so. Another was the state restrictions were voided, and the HMO was federally certified. The last provision was employers with more than 25 employees had to offer its employees a federally certified HMO plan. In 1995 the provision is for the companies to offer a federally certified HMO was abolished. Today there are different types of HMOs to fit the need of both the physicians and the patients. They have staff, group, and network models. Even though the models were designed to help both the physician and the patient to get quality and comprehensive medical care there is still negative views about HMOs. Many HMOs can combine different aspects with different models. In the staff model the physicians are directly employed by HMO and only see HMO patients’. This is called a closed-panel. A closed-panel is that of contracted physicians working only with HMO patients. The group model is another HMO model, where the physicians are not employed directly by HMO. Here the physicians are employed by a group and not HMO, but the group may be directly employed by HMO. When this is the case, it is called a “captive group model” (Minnesota Historical Society, n.d.). Then when HMO contracts but does not employ a physicians group is known as an “independent group model” (Minnesota Historical Society, n.d.). In this model physicians can see non-HMO patients.
Many people if financially able will choose an insurance plan, which is not HMO. They think there is too much run around with the HMO, and they cannot see who they want when they want. When the patients’ need to see a specialist they have to see an HMO physician who may not be the best. Physicians also choose not to accept HMO patients because they are only paid a flat rate for each HMO patient. Not only do they get less money for each patient, the physicians have to treat or refer their patients’ for all their medical needs. In order for the physician to refer his patients’ to a specialist, he has to follow the guidelines set forth by HMO. Even with the negativity HMO is good alternative health coverage. It may be a hassle for some people but everyone gets the same care no matter what type of insurance they have.

References
Minnesota Historical Society (n.d.); Health Maintenance Organizations; Retrieved from http://www.mnhs.org/library
Wikipedia, the free encyclopedia (2011, June 30); Health maintenance organization; Retrieved from http://en.wikipedia.org

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