reimbursement: health maintenance organization (HMO)
Any organization that, through an organized system of health care, provides or assures the delivery of an agreed-upon set of comprehensive health maintenance and treatment services for an enrolled group of persons under a prepaid fixed sum. Services usually include primary care, emergency care, acute hospital care, extended care, and rehabilitation. To be considered a "Federally Qualified Health Maintenance Organization," the HMO must meet the provisions of the HMO Act, P.L. 93-222, as amended in Title XIII of the Public Health Service Act.*
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*Extracted from Family Physicians and Managed Care: A View to the 90's: (paperback 1993) with permission from American Academy of Family Physicians
- Steinberg, Alan J, MD The Insider's Guide to HMOs - How to Navigate the Managed-Care System and Get the Health Care You Deserve Paperback 1997