Question: Which Of The Following Was The Objective Of The Health Maintenance Organization Act Of 1973?

Who regulates the quality of care provided by a health maintenance organization?

The US Health Care Financing Administration (HCFA) regulates HMOs and has instituted guidelines for reporting and quality assessment in an accreditation approach to quality assurance (see Chapter 15)..

Which of the following was the objective of the Health Maintenance Organization Act?

What was the purpose of the Health Maintenance Organization Act of 1973? … Its purpose was to provide insurance companies funds to start using HMOs with the idea that it would stimulate competition for enrollees therefore reducing costs.

What is the primary purpose of a health maintenance organization?

It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers (hospitals, doctors, etc.) on a prepaid basis.

What was the national HMO Act of 1973?

The Health Maintenance Organization (HMO) Act of 1973 was heralded as a major federal effort to change the health care delivery system by providing an alternative to the traditional solo practice fee-for-service system, in the form of the group practice prepaid plans, the health main- tenance organizations.

What problems did the HMO Act of 1973 address?

It provided grants and loans to provide, start, or expand a Health Maintenance Organization (HMO); removed certain state restrictions for federally qualified HMOs; and required employers with 25 or more employees to offer federally certified HMO options IF they offered traditional health insurance to employees.

How does capitation share risk with providers?

Capitation payments are used by managed care organizations to control health care costs. Capitation payments control use of health care resources by putting the physician at financial risk for services provided to patients. … Money in this risk pool is withheld from the physician until the end of the fiscal year.

What are the two generations of HMOs?

There are two generations of HealthMaintenance Organizations (HMO’s). The first generation of HMO is theKaiser- Permanente Medical Care Program. The second generation ofHMO is Network Model HMOs, Independent Practice Associations, andIntegrated Medical Groups.

What was the initial purpose of an HMO quizlet?

what is the initial purpose of an HMO (health maintenance organization)e? to track patient care. offers a higher deductible with a spending account for out-of-pocket expenses. describe the concept of primary and secondary coverage and what impact it has on health coverage.

What is gatekeeping briefly explain how it works?

Briefly explain how it works. Gatekeeping: arrangement in which primary care physician coordinates all health care services needed by an enrollee. Emphasizes preventive care, routine physical examinations, and other primary care services. Higher levels of services are obtained on the basis of referral from PCP.

What was the main purpose of the Health Maintenance Organization Act of 1973 quizlet?

The Health Maintenance Organization Act of 1973 was designed to provide an alternative to the traditional fee-for-service practice of medicine. It was aimed at stimulating the growth of HMOs by providing federal funds to establish new HMOs.

What are the two important components of an HMO?

What are the two important components of an HMO? – All medical services are provided based on a predetermined (per capita) fee and not on a fee-for-service basis. If the actual cost of services exceeds the predetermined (or capitation) amount, then the provider must absorb the excess in costs.

What is the definition of health maintenance?

Health maintenance is a guiding principle in health care that emphasizes health promotion and disease prevention rather than the management of symptoms and illness.