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New Developments in Health Care Delivery

State Impediments to the Organizatlon of For-Profit HMOs

Published online by Cambridge University Press:  01 January 2021

John A. Norris*
Affiliation:
Peabody, Brown, Rowley & Storey, Boston, Mass.

Extract

The letters HMO (short for Health Maintenance Organization) have very quickly become household words. In general, an HMO may be described as the organizational entity of a health care system which contracts with hospital and medical care providers on behalf of its enrolled members. More precisely, it is an organization, (usually a corporation) which accepts the responsibility to provide, directly or through contract, an agreed upon set of comprehensive health maintenance and treatment services for a volun. tariiy enrolled group of persons and is reimbursed through a premgotiated payment made by or on behalf of each person enrolled in the plan. (U. S. Department of H.E.W., Health Maintenance Organization [1971]).

HMOs can be either for profit or not for profit, although for profit HMOs are rare since establishing a for profit HMO involves the navigation of uncharted waters, containing many obstacles which most HMO organizers would prefer to avoid.

Type
Research Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 1973

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References

Unpublished memorandum by Westcott, C. and Norris, J. to Blue Cross-Blue Shield of Masoachusetts.Google Scholar
Hailey, R. and Carlson, R., The Legal Context for the Development of HMOs (1971).Google Scholar
Havighurst, C., HMOs and the Market for Health Services (1971).Google Scholar