Health Maintenance Organizations
GPTKB entity
Statements (51)
| Predicate | Object |
|---|---|
| gptkbp:instance_of |
gptkb:healthcare_organization
|
| gptkbp:aims_to |
Healthcare costs
|
| gptkbp:allows |
Out-of-network provider access
|
| gptkbp:benefits |
Individuals with chronic conditions
|
| gptkbp:can_be |
Limited provider networks
Member satisfaction ratings |
| gptkbp:can_provide |
Chronic disease management
Access to wellness resources Emergency care coverage Incentives for healthy behaviors |
| gptkbp:emphasizes |
Cost-effective care
|
| gptkbp:focus |
Preventive care
|
| https://www.w3.org/2000/01/rdf-schema#label |
Health Maintenance Organizations
|
| gptkbp:includes |
Preventive screenings
Group health plans Family coverage options Health services such as hospitalization |
| gptkbp:is_designed_to |
Reduce unnecessary healthcare services
|
| gptkbp:is_evaluated_by |
Quality of care metrics
|
| gptkbp:is_involved_in |
Health education initiatives
|
| gptkbp:is_known_for |
Coordinated care
|
| gptkbp:is_often_associated_with |
Prescription drug coverage
Lower premiums than traditional insurance |
| gptkbp:is_often_compared_to |
Preferred Provider Organizations (PP Os)
|
| gptkbp:is_often_used_in |
Employers seeking cost control
|
| gptkbp:is_part_of |
Public health programs
Employer-sponsored health plans |
| gptkbp:is_popular_in |
gptkb:United_States
|
| gptkbp:is_subject_to |
Federal regulations
|
| gptkbp:may_have |
Annual out-of-pocket maximums
Choice of specialists Network adequacy standards |
| gptkbp:negotiated_by |
Discounted rates with hospitals
Rates with healthcare providers |
| gptkbp:offers |
Mental health services
Telehealth services Preventive care services Wellness programs Flexible spending accounts Health savings accounts (HS As) |
| gptkbp:operates_under |
Capitation payment model
|
| gptkbp:purpose |
Provide health insurance
|
| gptkbp:regulates |
State insurance departments
|
| gptkbp:requires |
Prior authorization for certain services
Copayments for certain services Members to choose a primary care physician Referrals for specialist services |
| gptkbp:social_structure |
Non-profit or for-profit entities
|
| gptkbp:type_of |
gptkb:healthcare_organization
|
| gptkbp:bfsParent |
gptkb:Henry_Nixon
|
| gptkbp:bfsLayer |
3
|