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McLaren Health Care Corporation, headquartered in Grand Blanc, Michigan, includes 12 hospitals in Michigan, ambulatory surgery centers, imaging centers, a 490-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 732,838 lives in Michigan and Indiana, home health, infusion and hospice providers, pharmacy services, a clinical laboratory ...
Blue Cross Blue Shield of Michigan, a nonprofit mutual insurance company, provides and administers health benefits to more than 4.3 million members residing in Michigan in addition to members of Michigan-headquartered groups who reside outside the state. In 1998, BCBSM merged several HMOs it owned into the Blue Care Network HMO. [2]
By 2010, the company was the third largest Medicaid HMO in the country, with $2.5 billion in revenue and 800,000 members across Ohio and Michigan. [12] In 2010, CareSource announced expansion of its provider network in Southeastern Ohio through a partnership with Quality Care Partners (QCP), a physician-hospital organization (PHO).
From PPO to HMO, what's the difference between the 5 most common types of health insurance plans? MB Boucai, Data Work By Dom DiFurio October 23, 2024 at 11:45 AM
This model is an example of a closed-panel HMO, meaning that contracted physicians may only see HMO patients. Previously this type of HMO was common, although currently it is nearly inactive. [7] In the group model, the HMO does not employ the physicians directly, but contracts with a multi-specialty physician group practice. Individual ...
Unlike PPOs, however, HMOs often require members to select a primary care physician (PCP), a doctor who acts as a gatekeeper to direct access to non-emergency medical services, and are required to first obtain a referral from their PCP in order to be reimbursed for the cost of medical services inside of their network of designated doctors and ...
The terms "open panel" and "closed panel" are sometimes used to describe which health care providers in a community have the opportunity to participate in a plan. In a "closed panel" HMO, the network providers are either HMO employees (staff model) or members of large group practices with which the HMO has a contract.
It combines characteristics of the health maintenance organization (HMO) and the preferred provider organization (PPO). [1] The POS is based on a managed care foundation—lower medical costs in exchange for more limited choice. But POS health insurance does differ from other managed care plans.