Health maintenance organization

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Health Maintenance Organization (HMO)

Health Maintenance Organization (HMO) /ˈhɛlθ meɪntəˈneɪʃən ɔːrɡənaɪˈzeɪʃən/ is a type of health insurance plan that provides health services through a network of doctors, hospitals, and other healthcare providers. The term originated in the United States, but it is now used in various forms worldwide.

Etymology

The term "Health Maintenance Organization" was first used in the United States in the 1970s, as part of the Richard Nixon administration's efforts to reform healthcare. The term was intended to emphasize the plan's focus on preventive care and maintaining health, rather than simply treating illness.

Definition

An HMO is a type of managed care organization (MCO) that provides a form of health care coverage in the United States that is fulfilled through hospitals, doctors, and other providers with which the HMO has a contract. The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options.

Related Terms

  • Preferred Provider Organization (PPO): A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers.
  • Point of Service (POS): A type of plan where you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network.
  • Exclusive Provider Organization (EPO): A managed care plan where services are covered only if you use doctors, specialists, or hospitals in the plan’s network (except in an emergency).
  • Managed care: A way for health insurers to help control costs by coordinating healthcare services.
  • Preventive care: Routine healthcare that includes screenings, check-ups, and patient counseling to prevent illnesses, disease, or other health problems.

See Also

External links

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