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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]
These prepaid plans burgeoned during the Great Depression as a method for providers to ensure constant and steady revenue. In 1970, the number of HMOs declined to fewer than 40. Paul M. Ellwood Jr. , often called the "father" of the HMO, began having discussions with what is today the U.S. Department of Health and Human Services that led to the ...
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 ...
Provider-sponsored health plans can form integrated delivery systems; the largest of these as of 2015 was Kaiser Permanente. [ 30 ] Kaiser Permanente was the highest-ranked commercial plan by consumer satisfaction in 2018 [ 31 ] with a different survey finding it tied with Humana.
By 2010, CareMore had expanded to Northern California, Arizona, and Nevada. Serving over 50,000 patients, CareMore was acquired by WellPoint – now Anthem – in 2011 for $800 million. [7] [8] Between 2011 and 2016, CareMore diversified its care delivery services by providing care to Medicaid and Dual-Eligible patients in CA, NV, TN, OH, and IA.
The Health Maintenance Organization Act of 1973 (Pub. L. 93-222 codified as 42 U.S.C. §300e) is a United States statute enacted on December 29, 1973. The Health Maintenance Organization Act, informally known as the federal HMO Act, is a federal law that provides for a trial federal program to promote and encourage the development of health maintenance organizations (HMOs).
L.A. Care is governed by a 13-member stakeholder Board of Governors representing consumers, community clinics, physicians, hospitals, federally-qualified health centers, children's health care providers, and the Los Angeles County Department of Health Services. Two of the seats are held by consumers who are elected by L.A. Care enrollees.
California was one of the states to expand its Medicaid program. [6] As of 2018, about one-third of California was covered by Medi-Cal. It is administered by the California Department of Health Care Services, which operates it in accordance with California's Medicaid State Plan and Title XIX of the Social Security Act. [7]