Health administration within the HMO

Poll results demonstrating that patients argon at rest with their wellness maintenance organizations tend to reflect healthy patients. These people be the bag of the enrollees; they pay 20 percent to 30 percent little for their medical upkeep and they receive preventive medical care. delinquent to a curb budget, and the cost of serious or degenerative conditions, the HMO is not as efficient in these instances. The HMO is the authority in determining necessary treatments and decisions are make that benefit the organization; economics appear to be place ahead of medical care needs (Friedenberg, 1996).

The HMO has limited money that must be budgeted. It is reported that HMOs spend 80 cents of every premium dollar on medical care and the other(a) 20 cents on administration and profits; Kaiser spends 90 cents per premium dollar on health care. Profits are still accumulating. It is stated that in 199

Widra, L. S., & Fottler, M. D. (1992). Determinants of HMO success: The case of complete health. Health do Manage Rev, 17 (2), 33-44.

apprehend Health is considered a managed-care drawing card; its long-term goal is to be the leading HMO and health insurance manager in the southeast. The company is experiencing physician and enrollees' triumph and enrollment growth. The typical HMO faces the control of be and the grooming of quality care. While competitors are falling short in these areas, pad Health provides a successful example of incoming implications for the HMO (Widra & Fottler, 1992).

have it off Health provides an example of the implied changes needed for coming(prenominal) establishment and maintenance of the HMO. Included in their package is the concentrate on on customer satisfaction, a new management homunculus insuring physician independence, and a unique system to cut costs while maintaining quality care.

The success determinants of Complete Health are of interest for the future prosperous development of other HMOs. The Complete Health model was designed with input from a countrywide managed-care literature review, industry consultants, and a collection of operational experiences from across the nation. Flexibility is considered a core strength; it is expressed end-to-end the everchanging process of meeting consumer preferences and market acceptability (Widra & Fottler, 1992).

Unlike competitors, Complete Health was established as a for-profit enterprise with the lore and the reality of staying power in the industry and adequate capitalization. Complete Health is a privately held company. Peer group pressure is the central force driving the risk-sharing mechanism; in other words, it is the key ingredient needed for the reshaping inefficient practice into efficient ones. The peer review is fueled with economic incentives. Physicians receive master copy compensation on a fee-for-service basis, however, all payments are reduce to
Ordercustompaper.com is a professional essay writing service at which you can buy essays on any topics and disciplines! All custom essays are written by professional writers!