New Developments in Health Care Delivery

Abstract

The letters HMO (short for Health Maintenance Organization) have very quickly become household words. In general, an HMO may be described as the organizational entity of a health care system which contracts with hospital and medical care providers on behalf of its enrolled members. More precisely, it is an organization, (usually a corporation) which accepts the responsibility to provide, directly or through contract, an agreed upon set of comprehensive health maintenance and treatment services for a volun. tariiy enrolled group of persons and is reimbursed through a premgotiated payment made by or on behalf of each person enrolled in the plan. (U. S. Department of H.E.W., Health Maintenance Organization [1971]).HMOs can be either for profit or not for profit, although for profit HMOs are rare since establishing a for profit HMO involves the navigation of uncharted waters, containing many obstacles which most HMO organizers would prefer to avoid.