group model
Staff Model vs. Group Model
Gloria Brandon Essentials of Managed Care
National American University
Abstract
There are two types of Health Maintenance Organizations, you have the Staff Model and Group Model HMOs. With staff model it owns its own facilities and employs physicians, group model contracts with private health care providers to provide service to plan members and benefits are payable based on services and charges authorized by an HMO-affiliated doctor or representative.
Staff Model vs. Group Model
Staff Model HMOs- plan is paid on a “capitation” basis (“per head”), this means they receive a fixed sum of money each year to provide all of the medical care the enrollee needs no matter what. It offers the greatest incentive for cost control and cautious use of medical interventions (and to some observers, an incentive so strong that it might harm the patients’ health).
Group Model HMOs- are either “captive” or “independent”. Captive forms the group usually a large multi-specialty group, independent contracts with and existing group to provide physician services to members. And group model shares advantages of staff model HMOs.
What appeals to physicians that work with staff model HMOs are salaried employees. One of the major benefits in staff model HMO, the salary is guaranteed, work hours are fairly regular. A practice administrator handles the business aspect this leaves the physicians free to do what they do best take care of his or her patients. Also staff model HMOs are convenient to patient care, such as labs, and radiology facilities and other types of diagnostic equipment. Physicians that are in staff model HMOs have more control over health care delivery.
In a group model HMO physicians benefits are similar to those in the staff model HMOs. Physician’s hours are more regular and they are salaried. In this model the physicians practice through requirements and the like.
PPOs are more appealing to patients because of the
Gloria Brandon Essentials of Managed Care
National American University
Abstract
There are two types of Health Maintenance Organizations, you have the Staff Model and Group Model HMOs. With staff model it owns its own facilities and employs physicians, group model contracts with private health care providers to provide service to plan members and benefits are payable based on services and charges authorized by an HMO-affiliated doctor or representative.
Staff Model vs. Group Model
Staff Model HMOs- plan is paid on a “capitation” basis (“per head”), this means they receive a fixed sum of money each year to provide all of the medical care the enrollee needs no matter what. It offers the greatest incentive for cost control and cautious use of medical interventions (and to some observers, an incentive so strong that it might harm the patients’ health).
Group Model HMOs- are either “captive” or “independent”. Captive forms the group usually a large multi-specialty group, independent contracts with and existing group to provide physician services to members. And group model shares advantages of staff model HMOs.
What appeals to physicians that work with staff model HMOs are salaried employees. One of the major benefits in staff model HMO, the salary is guaranteed, work hours are fairly regular. A practice administrator handles the business aspect this leaves the physicians free to do what they do best take care of his or her patients. Also staff model HMOs are convenient to patient care, such as labs, and radiology facilities and other types of diagnostic equipment. Physicians that are in staff model HMOs have more control over health care delivery.
In a group model HMO physicians benefits are similar to those in the staff model HMOs. Physician’s hours are more regular and they are salaried. In this model the physicians practice through requirements and the like.
PPOs are more appealing to patients because of the