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Essay / Research Paper Abstract
A 24 pages research paper that explores various questions on managed care. The questions address such topics as HMO and PPO differences, and the compensation system for physicians and hospitals. Bibliography lists 25 sources.
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24 pages (~225 words per page)
File: D0_khmancq.rtf
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Unformatted sample text from the term paper:
exclusively to its own providers for a premium payment of 50 cents per member per month. This is regarded by many as the first example of an health maintenance organization
(HMO) (Fox, 2003). In 1929, Dr. Michael Shadid started a rural farmers cooperative health plan in Oklahoma. Farmers pay a membership fee of $50 each in order to raise the
money to build a hospital. Their membership allowed them discount medical services at the hospital when it was built. During the Depression, hospitals began instituting pre-paid plans, known as "Blue
Cross and Blue Shield" plans, in order to protect and enhance their patient revenues (Fox, 2003). Physicians found this movement threatening and in 1932 the American Medical Association (AMA) formulated
a strong position against prepaid group practices (Fox, 2003). The AMA favored, instead, indemnity-type insurance. The AMAs stance set the tone for continued opposition to prepaid group services. Nevertheless,
the years preceding and following World War II witnessed the formation of several HMOs that are still prominent today. For example, the Kaiser Foundation Health Plans began in 1937 (Fox,
2003). The role of HMOs remained modest throughout the 1960s and early 70s. In 1973, Congress tried to spur the development of managed care with the HMO Act. However, due
to the fact that it placed requirements on HMOs that were not in place on indemnity carriers, it actually served to reduce the ability of HMOs to be competitive (Fox,
2003). The 1970s and early 80s saw the development of preferred provider organizations (PPOs), which are organizations comprised of health care providers that offer services at a reduced fee (PPO,
2003). A PPO is similar to an HMO, but health care services are paid for as they are received instead of in advanced in accordance with a fee schedule (PPO,
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