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HMO
Health Maintenance Organization is a specific type of health care plan found in the United States. Unlike traditional health coverage, an HMO sets out guidelines under which doctors can operate. On average, health care coverage through the use of an HMO costs less than comparable traditional health insurance, with a trade off of limitations on the range of treatments available.
The ways in which an HMO is able to offer cheaper health care are twofold. First, by contracting with specific providers of health care and dealing with large quantities of patients, the HMO is able to negotiate for more affordable health care than the patients would otherwise receive. Secondly, by eliminating treatments that the HMO views as unnecessary, and by focusing on preventative health care with an eye toward the long term health of their members, the HMO reduces costs.
When one joins an HMO, one is usually asked to choose a primary care physician. This doctor then acts in part as the HMO’s agent in determining what treatments the patient does and does not need. When the primary care physician determines that the patient needs care they cannot offer, they give a referral to a specialist that can address the patients concerns. Emergency visits are exempt from this referral limitation, of course, and in many cases women are able to choose an OB/GYN as well.