Journal Article

A National Survey of the Arrangements Managed-Care Plans Make with Physicians

Lake, Timothy, Gold, Marsha R, Ensor, Todd, Berenson, Robert, Hurley, Robert

1995

Overview

Under managed care, the financing and delivery of health care are organized by a single entity. Managed-care plans are classified as health maintenance organizations (HMOs), preferred-provider organizations (PPOs), or various mixes of the two. 1 There are two major forms of HMO: group-model or staff-model HMOs and network or independent-practice–association (IPA) HMOs. Both types are usually at risk for the costs of care and therefore often control costs by requiring patients to be referred to specialists by primary care doctors. The doctors in network or IPA HMOs are usually in independent practice. A PPO, in contrast, consists of a group of . . .

• Publisher: Massachusetts Medical Society
• Subject: Biological and medical sciences / Capitation Fee / Data Collection / Health and social institutions / Health maintenance organizations / Health Maintenance Organizations - economics / Health Maintenance Organizations - organization & administration / HMOs / Independent Practice Associations - economics / Independent Practice Associations - organization & administration / Managed care / Managed Care Programs - economics / Managed Care Programs - organization & administration / Medical sciences / National institutions / Organizations and institutions for the application of policies / Physicians / Physicians - economics / Physicians - organization & administration / Physicians - standards / PPOs / Practice Patterns, Physicians' - economics / Preferred Provider Organizations - economics / Preferred Provider Organizations - organization & administration / Public health. Hygiene / Public health. Hygiene-occupational medicine / Salaries and Fringe Benefits / United States / Utilization Review