Health Maintenance Organizations (HMOs)

GPTKB entity

Predicate	Object
gptkbp:instanceOf	Health insurance organization
gptkbp:abbreviation	HMO
gptkbp:acceptsPaymentMethod	gptkb:Capitation Prepaid health plan
gptkbp:businessModel	Integrated delivery system
gptkbp:countryOfOperation	gptkb:United_States
gptkbp:distinctFrom	gptkb:Preferred_Provider_Organization_(PPO) gptkb:Exclusive_Provider_Organization_(EPO) Point of Service (POS) plan
gptkbp:example	gptkb:Aetna gptkb:Health_Net gptkb:Humana gptkb:Kaiser_Permanente gptkb:UnitedHealthcare
gptkbp:feature	No coverage for out-of-network care (except emergencies) Emphasis on prevention Limited provider choice Lower premiums
https://www.w3.org/2000/01/rdf-schema#label	Health Maintenance Organizations (HMOs)
gptkbp:offers	Medicaid managed care plans Medicare Advantage plans
gptkbp:originatedIn	1970s
gptkbp:purpose	Provide managed health care
gptkbp:regulates	gptkb:Centers_for_Medicare_&_Medicaid_Services_(CMS) gptkb:Health_Maintenance_Organization_Act_of_1973 State insurance departments
gptkbp:relatedConcept	gptkb:Primary_care_physician gptkb:insurance gptkb:Affordable_Care_Act Premium Managed care Referral system Preventive medicine Copayment Deductible Network provider Out-of-pocket maximum Utilization review
gptkbp:requires	Referrals for specialists Primary care physician selection
gptkbp:roadType	Closed network
gptkbp:serviceType	Primary care Preventive care Hospital care Specialist care
gptkbp:targetAudience	Families Individuals Employers
gptkbp:bfsParent	gptkb:Capitation
gptkbp:bfsLayer	8