Health Maintenance Organizations - Legislation & jurisprudence
Research News and Information

Monday, November 23, 2009

Medicare spending on HMOs and stand-alone drug plans: what is it worth to beneficiaries?

30 Oct 2008 (1) Medicare beneficiaries value the expansion of stand-alone prescription drug plans more than they value the expansion of HMOs. (2) The addition of subsidized stand-alone prescription drug plans generates nine times as much value per government ... Read more...

Principles versus procedures in making health care coverage decisions: addressing inevitable conflicts.

4 Jun 2008 It has been suggested that focusing on procedures when setting priorities for health care avoids the conflicts that arise when attempting to agree on principles. A prominent example of this approach is "accountability for reasonableness." We will ... Read more...

The impact of the adoption of gag laws on trust in the patient-physician relationship.

29 Sep 2007 Physician organizations, policy makers, and patient advocates have expressed concern that health plans have contractually limited the freedom of physicians to communicate with their patients. In response, many states have adopted gag laws that limit ... Read more...

Latest indexed articles for 'Health Maintenance Organizations - Legislation & jurisprudence'

These are the very latest articles for this heading:

• Medicare and HMOs--the search for accountability. 12 May 2009
• Legislation: where does health care fit in? 30 Mar 2009
• Address of the Keynote Speaker. CSMS House of Delegates--annual meeting. September 24, 2008. 30 Oct 2008
• Medicare spending on HMOs and stand-alone drug plans: what is it worth to beneficiaries? 30 Oct 2008
• Principles versus procedures in making health care coverage decisions: addressing inevitable conflicts. 4 Jun 2008
• Promises, promises. 30 Mar 2008
• Important lessons learned. 28 Feb 2008
• Calif. wants another slice of UnitedHealth pie. PacifiCare violations could cost insurer up to $1.3 billion. 2 Feb 2008
• [Health-care system and quality management--how much self-deception is allowed?] 30 Jan 2008
• Class action lawsuits against health insurers: the HMO settlements. 30 Dec 2007
• The impact of the adoption of gag laws on trust in the patient-physician relationship. 29 Sep 2007
• Nev. merger still faces roadblocks. State attorney general may file federal lawsuit. Sep 2007
• Kaiser probed again. More patient dumping alleged in Los Angeles area. 21 Jul 2007
• Physicians win again. 29 Jun 2007
• Discharge planning Advisor. Homeless pose unique discharge challenge. 29 Jun 2007
• The big money in Medicaid. A boom in HMOs for the neediest leads to litigation, controversy--and lots of profits. 23 Jun 2007
• The political management of managed care: explaining variations in state health maintenance organization regulations. 30 May 2007
• Eligibility, treatment, or something in-between? Plaintiffs get creative to get past ERISA preemption. 30 Dec 2006
• Kaiser report provides empirical foundation for addressing health care needs of the uninsured. 30 Dec 2006
• La. judge mulls motion on HMO. Oath's defense wants case ended, says no crime alleged. 9 Dec 2006

See a longer list of these articles.

Technical information about 'Health Maintenance Organizations'

Definition: Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)

Descriptor UI: D006279

Alternative terms: Health Maintenance Organizations; Prepaid Group Health Organizations; HMO; Organizations, Health Maintenance; Group Health Organizations, Prepaid; Health Maintenance Organization; Organization, Health Maintenance;

Allowable Qualifiers: classification; economics; history; legislation & jurisprudence; manpower; organization & administration; standards; trends; utilization; statistics & numerical data; ethics;

Tree Number: N03.219.521.576.343.800.400; N03.219.521.576.343.925.400; N04.452.758.244.425; N04.590.374.410.400;

History Note: 74(71)

Technical Notes: DF: note short X ref