Healthcare Organization

Topics: Health insurance, Preferred provider organization, Health care Pages: 5 (1611 words) Published: May 16, 2011
Healthcare Organization's - HMO vs. PPO
Angela MacLeod, Ifeoma Jonathan
April 17, 2011
Jeffery Dodd

Healthcare Organization's - HMO vs PPO
A health care system is the organization of people, institutions, and resources to deliver health care services to meet the health needs of target populations. There are two widely known and used healthcare organizations that deliver insurance to the vast majority of the population, Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO). This document will further compare these organizations in how they communicate, management style, motivation, culture, conflict resolution and ongoing management development. Communication skills

Health Management organization (HMOs) and the Preferred Providers Organization (PPOs) are service providers and require effective communication skills to reach out to the consumers and sustain business. Effective communication is often top of the list of attributes employer look for in a job (Lombardi D.M., & Schermerhorn J. R., 2007), whereas for service and goods consumers communication skills and style are effective tools to sell services. HMOs and PPOs use both incoming and outgoing communication skills to sell health products. Outgoing communication skills include giving of “directives, directions, consultation, demands, expectation, guidance, feedback and referrals” (Lombardi D. M., & Schermerhorn J. R., 2007) for services provided. Here the consumer or subscribe is critical to incoming communication as the health providers provided the needed information for the consumers care. Outgoing communication comprises of, “compliance, professional development, action, growth team insight, leadership, contribution and, expertise, satisfaction and, expectation, fulfillment (Lombardi D. M., & Schermerhorn J. R., 2007) to achieve efficiency and reliability in services. In outgoing communication the employees are mainly under consideration. Nonverbal communication is communication tool available to the HMOs and PPOs, nonverbal communication show cases the work behaviors and culture and how user perceives the services. Communication in both organizations is written and verbal and both require that the organizations build effective way of sending and receiving information. HMOs and PPOs use same communication skills to achieve business goals. As service providers, communication should be effective for consumer’s patronage. Patronage is likely id consumers decode messages sent. The incoming and outgoing communication strategies are pertinent to both organizations Management style

Health management Organizations (HMOs) and Preferred Providers Organizations (PPOs) are types of insurance that provide managed care through a group of health care providers for the subscribers. HMOs subscribers choose a Personal -Care -Physician (PCP) also called gatekeepers. The gatekeeper manages the health needs of the consumer. However, the subscriber determines accessibility to a PCP within his or her territory. Location of the health provider is critical as treatment out of network chain attracts extra cost. Health Management Organizations provides annual premium because cost is shared among members. This is an added advantage to the subscriber. HMOs key into the paperless office and they do less paperwork. HMOs focusing more on preventive health, and this of value as preventive services promotes a healthier life .HMO scheme are beneficial to users with medical conditions, who receive routine care as access to care attracts little extra cost. A known disadvantage of subscribing to HMOs is that access to specialist care is limited, this so as “ health care costs running at 11-12 percent of our gross national product, cutting the cost of health care has become a national priority” (Kennedy D.W ,1990). Increased...
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