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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[Freeeedom!]

Hate to sound bad...but read up and form your own opinions.

 

[Gauravvv]

There have already been a couple of really good threads on HMOs, im sure youll get the info you want if you search for it

 

[Popoy]

Originally posted by 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•

This is a question often ask by many students especially those that are going to be interviewing soon.

Besides searching the studentdoctor forums, you may want to go to your local library and look under NEWSWEEK and TIMES.... I remember those two magazines having cover pages about HMO's, PPO's, etc....

I'm sure you'll find your resources.... Good luck....

 

[Vince]

If you are interested, a good all around text on health care is:

Sultz and Young. Health Care USA: Understanding Its Organization and Delivery, 2nd ed. 1999: Aspen Publishers Inc.

I used it for a course in current health care issues for undergrad and it has ample information on HMO's(Health Maintenance Organizations) as well as other concerns. I reviewed it along with my notes from the class in preparation for my interview. On a side note, I wasn't asked anything about HMO's during my interview. Better safe than sorry I guess.

Good Luck

Vince2184
MS-I, Western U/COMP

 

[tedsadoc2002]

I realize I interviewed quite a while ago, but what I did (back in the stone ages) was to use a search engine (like lycos) put in HMO and I got a slew of information, sites that had definitios (like what an HMO is/does vs. a PPO, etc.). I was able to use this stuff to study from in case I got asked a question on HMO's. Fortunately, I didn't have to answer those questions. Good luck.

 

[DO/MBA]

OK,
HMO actually stands for Health Maintenance Organization. Generally there are two methods of payment for these bodies of business.
1. Capitation: Capitation is when the company pays you x amount of dollars per person. This payment per person is negotable and it depends on the age group. The HMO will pay you this money in monthly insallments regardless of whether you see the patients or not. The advantage is you get patients. (It is part of the deal when signing with the HMO. They send you there patients.) Another advantage is it stresses preventative medicine. (If the patient comes in and has to have a lot of tests done it comes out of you pocket. So you tell them to relax on the fatty foods.) The disadvantage is that they keep negotiating the payment per person down to a point where you make little money. Also, there is no incentive to work.
2. Fee for service: This is another mode of payment used by PPO's (traditional insurance companies). What they do is they negotiate a contract to put you on a plan. (similar to HMO's but not as exclusive) Then say we will pay you for the service that you do at 115% of what medicare pays. (Looks good but medicare doesn't pay squat.)
There are other payment methods out there DRG and per diem (day) or per case, and they are usually for long hospital stays ect.
Oh and "Managed Care" should be renamed "Managed Cost" It is the USA's way of controlling health care costs.