Health Insurance Articles
The Role Of HMOs In The New Health Provider Landscape
2010-12-09
Health insurance has changed in recent years as companies have faced increasing competition from both new competitors in the marketplace and the federal government itself. For individuals and families that are seeking health insurance plans, this increased competition in addition to increased accessibility of quotes via the internet has meant that in many cases they are able to obtain rates that are more reasonable and find polices that are more balanced and fair. The "original" American health plans - HMO plans - have even undergone some changes in order to still be viable in the new health care landscape. While other options do exist that allow more flexibility, there are still a number of ways that HMO plans are staying relevant in the new health market.
An HMO or "health management organization" is a network of doctors that have agreed to treat patients under the care of the health plan for a reduced cost. They do this because of the steady business the plan grants them and the fact that many plans are large enough to keep them in business for a very long time. These networks of doctors can span cities and states, giving patients access to a variety of care services. In addition, many HMO plans include specialists on their roster which allow patients to see them without the need for a referral from the family doctor first and for far less cost than would be paid if they were to seek out these specialists on their own.
Where HMO plans have run into trouble is coming up against things such as PPOs and self-directed plans. These options lend themselves to greater flexibility and customer choice, which can often lead to a derision of the services provided by traditional HMOs. Those in PPO and self-directed plans often hail the benefits of being able to choose their own providers and not be bound to the network that the plan sets up. In many cases, however, HMOs are just as relevant as either of the two newer plans for several reasons. The first is simple longevity - HMOs have been around for a long time, and many have amassed scores of excellent doctors based on their reputation alone. In addition, some HMOs have begun to create health centers that are not only state of the art but that are staffed entirely by members of their provider network, offering patients easy access to services.
As the federal health plan begins to deploy, the landscape of health care will once again change. While it is impossible to predict the ultimate outcome for HMOs, they are doing their best to remain relevant in a new and changing health care world.
