a really dumb question

[realruby2000]

a possible interview question....

"what do you think about hmo's?"

i dont mean to sound ignorant here...but all i know about HMO's is that they stand for Health Management Organizations...I think..(what exactly is managed care anyway?) What else is there to hmo's besides the fact that they like to flood docs with patients and are sometimes reluctant to pay for some important tests and procedures?

thanks

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[THE instiGATOR]

Realruby, are you a "military brat"? I am, and have never had to worry about insurance coverage. If I needed something, the military provided it. I too would like to know more about HMOs, though I do think I have some knowledge.

 

[Sonya]

you could look up some articles in JAMA. look in an index issue for the subject HMO or managed care. then get a few basic articles and read them.

oh, and this page has links to some term papers i wrote on managed care, HMO, physician supply, etc
http://sonyadave.bizland.com/research.chtml

 

[TwoSteveSquared]

HMO stands for Health Maintanance Organization.

It is a network of docs who are paid by CAPITATION (a bad word). They are basically paid a base salary according to the number of patients that are in their network. So if a doc spends a lot of time with one patient (i.e. extra tests, check-ups, etc.), it kinda costs him money indirectly, cause he will make more if he can see more patients.

Finally, the best part, HMO business men decide which procedures are um...cost effective (like that has any place in medicine). So docs are limited to cost efficient treatment methods. They also need to get most tests and treatments approved, taking away autonomy. That's what a lot of patients and docs in HMOs complain about most.

The one, and only, advantage: efficient medicine means lower insurance premiums, so the middle class can afford health care.

If you want more info, look up "The Soul of an HMO" an article in an old Time magazine (the archive is online, but you'll have to pay for the article).