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The typical IPA encompasses all specialties, but an IPA can be solely for primary care, could be single specialty, or could be a set of other care providers such as psychologists or even providers of social services such as food pantries, homeless shelters, or substance use disorder treatment facilities. [2] [3]
Bruce Broussard, former chief executive officer of Humana [13] Richard T. Burke , founder of UnitedHealth, chief executive officer until 1987, and chairman of the board from 2006 to 2017 [ 14 ] William H. Donaldson , former chairman, president, and chief executive officer of Aetna [ 15 ]
Humana Inc. is an American for-profit health insurance company based in Louisville, Kentucky. In 2023, the company ranked 42 on the Fortune 500 list, [2] which made it the highest ranked (by revenues) company based in Kentucky. It is the fourth largest health insurance provider in the U.S. [3]
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 ...
Providers may be employees of the HMO ("staff model"), employees of a provider group that has contracted with the HMO ("group model"), or members of an independent practice association ("IPA model"). HMOs may also use a combination of these approaches ("network model").
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CAQH was formed by a number of the nation's largest health insurance companies with the goal of creating a forum for healthcare industry stakeholders to discuss administrative burdens for physicians, patients, and payers. [5] CAQH is a group of health insurance companies that sets rules and coordinates information for physicians and other ...
In U.S. health insurance, a preferred provider organization (PPO), sometimes referred to as a participating provider organization or preferred provider option, is a managed care organization of medical doctors, hospitals, and other health care providers who have agreed with an insurer or a third-party administrator to provide health care at ...