Health maintenance organizations: structure, performance, and current issues for employee health benefits design
Article Abstract:
Health maintenance organizations (HMOs) are prepaid, organized care systems that were started as a health care alternative to fee-for-service health care. The goal of HMOs is to provide more comprehensive and affordable health coverage. The plan operates by charging a fixed fee that is paid in advance by each member. In return, the HMO provides the needed medical services with minimal out-of-pocket cost for the patient. HMOs integrate financing and delivery of medical services, and are responsible for arranging and providing all necessary medical care including the benefit package. The advantages of HMOs include lower out-of-pocket costs, comprehensive first-dollar benefits, and fewer claims forms with less paper work. Recent studies have indicated that HMOs are more cost-effective than conventional health care plans. Results from the Rand National Health Insurance Experiment showed that medical costs in HMOs were 25 percent lower than those in fee-for-service plans. Studies aimed at evaluating the quality of care revealed that HMOs provided superior quality health care in 19 out of 27 studies and equal health care in 8 out of 27 studies compared with fee-for-service plans. The results of a national survey on customer satisfaction of HMOs showed that 90 percent were satisfied with their doctors and 76 percent were satisfied with the quality of hospital care provided through HMOs. When employers were questioned about their perceptions of the ability of HMOs to control medical costs it was found that 32 percent felt that HMOs were effective in controlling costs, 32 percent disagreed, and 35 percent were neutral. Despite the advantages of HMOs, employers reported higher overall satisfaction with conventional plans. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1991
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Closing the loop on employee training
Article Abstract:
The adoption of the right assessment method to employee training is an important feedback to the success of the trainor's goal and the trainee's absorption of the skills and knowledge needed to reach that goal. The assessment can either be performance- or knowledge-based. Results could be reported to trainees either through data or group reporting or individual feedback. In any case, the assessment tool to be used should be a product of solid planning.
Publication Name: Hospital Material Management Quarterly
Subject: Health care industry
ISSN: 0192-2262
Year: 1995
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Certification Maintenance - Professional Preventive Maintenance Program Offered
Article Abstract:
The Healthcare Financial Management Association (HFMA) offers a program for members to maintain professionalism through certification maintenance. Educational activities, programs, writing and participation earn points for certification maintenance. The requirements for the program are outlined.
Publication Name: Healthcare Financial Management
Subject: Health care industry
ISSN: 0735-0732
Year: 1984
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