Health Maintenance Organizations

URI: https://gptkb.org/entity/Health_Maintenance_Organizations
GPTKB entity
Statements (52)
Predicate Object
gptkbp:instanceOf gptkb:insurance
gptkbp:abbreviation HMO
gptkbp:acceptsPaymentMethod capitation
gptkbp:advantage lower out-of-pocket costs
coordinated care
referral requirements
restricted provider network
gptkbp:component managed care
gptkbp:countryOfOrigin gptkb:United_States
gptkbp:criticizedFor prior authorization requirements
denial of coverage
limited provider choice
gptkbp:emphasizes preventive care
gptkbp:establishedIn 1929
gptkbp:focus integrated care
gptkbp:mayInclude dental coverage
prescription drug coverage
vision coverage
gptkbp:notableExample gptkb:Aetna
gptkb:Health_Net
gptkb:Humana
gptkb:Kaiser_Permanente
gptkb:UnitedHealthcare
gptkbp:offers Medicaid managed care plans
Medicare Advantage plans
chronic care management
health insurance plans
wellness programs
disease management programs
telemedicine services
case management services
gptkbp:prohibits out-of-network coverage
gptkbp:purpose provide managed healthcare
gptkbp:regulates gptkb:Centers_for_Medicare_&_Medicaid_Services
gptkb:Health_Maintenance_Organization_Act_of_1973
state insurance departments
gptkbp:relatedTo gptkb:Preferred_Provider_Organizations
gptkb:Exclusive_Provider_Organizations
gptkb:Point_of_Service_Plans
gptkbp:requires gptkb:enrollment_period
copayments
monthly premium
primary care physician selection
referral for specialist care
gptkbp:roadType closed network
gptkbp:target quality improvement
cost control
gptkbp:bfsParent gptkb:HMOs
gptkb:Florida_Medicaid_Managed_Care
gptkb:Medicare+Choice_program
gptkbp:bfsLayer 6
https://www.w3.org/2000/01/rdf-schema#label Health Maintenance Organizations