Skip to main content.

HMOs: Health Care Cost Containment

Useful Resources

HMOs: Health Care Cost Containment

December 16, 2008

Health Maintenance Organizations (HMOs) are a form of insurance-financed managed care. In a managed care system, a health insurance plan pays a closed network of doctors and hospitals an annual rate for each enrollee regardless of how much health care that enrollee uses. If a group of enrollees uses less health care than the insurance company paid for in advance, the doctors and hospitals keep the difference as a bonus. This system is called "capitation." A primary care doctor typically acts as a gatekeeper for an HMO enrollee and refers him to a closed network of specialists when necessary. Theoretically, managed care should keep health care costs down by providing doctors with incentives to keep their patients healthy and avoid expensive hospital care. HMOs became very popular in the late 1980s and throughout the 1990s as a cost-containment method, but in recent years, patients began to revolt against them. Some patients didn't like the closed provider network, and others questioned their physician's and insurance companies' motives when they were denied care. Almost 64.5 million people belonged to an HMO as of July 2008, according to StateHealthFacts.org, a website sponsored by the Henry J. Kaiser Family Foundation. This is their most recent estimate as of August 2009. Updated February 2010

Announcements

The engagement editor's mission: to advance the work of our California media partners, furthering public knowledge, storytelling, engagement and connection around community health and health policy issues in diverse communities. The ideal candidate will have both journalism and community engagement experience. Go to this link to apply.

CONNECT WITH THE COMMUNITY

Member Activities

Marisa Kwiatkowski joined the community

Connect with Marisa Kwiatkowski

Bethany Barnes joined the community

Connect with Bethany Barnes

Tracie Potts joined the community

Connect with Tracie Potts

Emmanuel Felton joined the community

Connect with Emmanuel Felton

Josephine Valenzuela joined the community

Connect with Josephine Valenzuela
More Member Activities

Follow Us

Facebook


Twitter

CHJ Icon
ReportingHealth