How has the relationship between the government and HMOs changed over the past seven years?
How do HMO plans differ from PPO plans?© BrainMass Inc. brainmass.com October 10, 2019, 2:12 am ad1c9bdddf
Hope this helps you.
Thanks for using BrainMass.
The government relation with the HMOs was broaden by the Balanced Budget Act (BBA) of 1997 when it opened Medicare health plan options to enrollees by adding Medicare-contracting HMOs to the Medicare fee for services standard option. Later the BBA was amended to provide the option to the states to contract "on a risk basis with "any public or private organization," including a health maintenance organization [HMO]" (KFF.org, 1997, para. 3) to provide services for Medicaid. The government contractual relationship with HMOs has been progressively increasing the last five years. A report on the plan enrollment patterns and trends of Medicare Advantage in 2010 stated that 65% of the enrollees in 2010 were in HMO ...
The solution involves an explanation of how an HMO differs from a PPO plan as well as the change in the relationship that the government had in the last seven years due to the Balance Budget Act of 1997.