Purchase Solution

Basics of HMO and PPO plans

Not what you're looking for?

Ask Custom Question

What is a HMO?
What is a PPO?
Which do you feel is better?

Purchase this Solution
Solution Summary

The solution includes an explanation of what is a PPO or preferred provider organization and a HMO or health maintenance organization, how they work, and their advantages and disadvantages.

Solution Preview

Hi,
Hope this helps you.
Thanks for using BrainMass.

The HMO or health maintenance organizations are entities that focus on preventive services and wellness. The organizations have a predetermine range of health care services allowed and use a primary care physician as "gate keeper" to coordinate care and utilization of services. The patients are restricted to use those providers of services that participate with the insurance and health care services approved.
The patient requires a referral from the primary care provider to access those services. For most specialized services, the primary care physician is responsible to provide the insurance with the appropriate information. The insurance then proceeds to review treatment requests for appropriateness ...

Purchase this Solution
Free BrainMass Quizzes
CPR (Red Cross Standards)

Are you up to date on your CPR skills? Find out if you know what to do in an emergency with this quiz.

Stress Continuum

All humans experience stress and a certain level is motivating for learning. However, a high level of stress for prolonged periods of time may have a negative impact. This information focuses on the four stages of stress. Understanding stress assists in maintaining a healthy level.

Fibromyalgia

This quiz provides a brief overview of Fibromyalgia. Research is currently evolving regarding this diagnosis.

Crohn's Disease

How much do you know about this condition?

Test your health planning and program evaluation knowledge

Health planning and program evaluation is an important aspect of the Health Sciences' field. Organizations and communities must understand the needs of their audiences, and a way to obtain this datum is through proper design and assessment. This quiz will test your ability to understand the importance of planning and evaluation in the health sector.

View More Free Quizzes
Related BrainMass Solutions

  • promoting products

    343750 Contrast approaches to promoting products to a PPO and to a staff model HMO. You are in charge of marketing your company's laboratory services to managed care plans in your region.

  • Quality Plan for HMOs' and PPOs

    The PPO by nature enables the patient to choose their own preferred provider but will pay a smaller percentage of the costs associated with the costs. Quality plans for HMO's and PPO's.

  • Managed Healthcare Organizations

    Cite any sources in APA format. http://www.insurance.com/health-insurance/health-insurance-basics/understanding-the-difference-between-hmo-ppo-and-pos.aspx • What are the positive and negative aspects of managed care?

  • HMOs, PPOs and govenment

    367446 Health Services- HMO and PPO How has the relationship between the government and HMOs changed over the past seven years? How do HMO plans differ from PPO plans? Hi, Hope this helps you. Thanks for using BrainMass.

  • PFFS vs HMO Comparison: Describe and Compare Fee-for-Service Plans and Managed Care Plans

    POS-Point-of-Service plans have features of both the HMO and PPO. In a POS, primary care doctors can refer to providers outside the plan, and the insurance will provide some coverage.

  • Models of Managed Healthcare

    HMO, PPO, and exclusive plans such as Kaiser are discussed. NHS is used as an example of a system in a first world country that works for all people.

  • HMOs and PPOs versus traditional health care providers.

    Deductibles are typical for out of network expenses and there is a higher co-payment. Traditional Health Care Providers: Traditional Health Care Providers used to be the standard prior to the advent of HMO and PPO options.

  • Characteristics of various popular managed care models

    511055 Characteristics of various popular managed care models compared with traditional indemnity insurance plans Outline the characteristics of various popular managed care models (i.e., HMO staff model, HMO group model, IPA, PPO, EPO, etc.) and compare

  • Managed Care & Contractual Services

    provided through PPO care plans.

View More Related Solutions