The Quality of Health by Health Medical Organization

The quality of health care which a population receives is predetermined by a skillfully chosen management plan. Health Medical Organization is a certain strategy of managed care planning used by a healthcare institution to regulate the relationships between it, a physician, and a patient. This term was coined by Paul Ellwood (as cited in Marcinko & Hetico, 2011) who narrows the concept of HMO to “a group responsible for both the financing and delivery of health to an enrolled population” (p. 14). The HMOs major benefit lies in doctors acquaintance with each patients family, social, and financial situations that is a solid basement for a qualified health care (Hunter, n.d.). There are two major types of HMOs subdivided into various specific models having both advantages and disadvantages that are described in the given paper.

HMOs Types

The classification of HMOs is based on their peculiarities that appear in the relationships between physicians, the members of these organizations who get medical service, and the health care institutions. Open-panel and closed-panel plans are two major types of health medical organizations. Open-panel HMOs include private physicians legally agreeing to provide the HMOs members with health services. These private health care providers should only accept the specific terms of HMO and meet all its criteria (Kongstvedt, 2013). On the contrary, closed-panel HMO is based on the medical service provided by a single medical group associated with the HMO (Kongstvedt, 2013). Closed-panel HMOs are considered to be more old-fashioned, which is confirmed with Marcinko and Hetico (2011) claiming that open-panel HMOs “give physicians more latitude for independent thought and decision-making skills” (p.14). A deeper classification is provided with a further subdivision of these major types of HMOs.

Traditionally, open-panel HMOs include two models of collaboration with private health care providers. The first one is called an independent practice association model. It is based on the absence of the direct contraction between physicians and HMOs (Kongstvedt, 2013). It means that a doctor is not legally affixed to his/her HMO, which gives him an opportunity to be an incumbent member of another medical institution, have personal offices and medical crews, and treat non-HMO patients. On the other hand, the second type of open-panel HMOs called direct contract model diversifies the relationships between physicians and HMOs. The connection is based on the direct contract between a physician or a medical group with HMO (Kongstvedt, 2013). In this case, the outer activities of a private health care provider are restricted by the terms of employment, although a physician remains a private practitioner.

Closed-panel HMOs include two models of collaboration as well. The first one called a group model aims to create multispecialty groups that are contracted by HMOs and provide versatile services to HMOs members (Kongstvedt, 2013). Marcinko and Hetico add that the physicians referring to a group practice are allowed to work in a private office and treat non-HMO patients as well (Marcinko & Hetico, 2011). The group members share the same equipment, medical documentation, facilities, and supporting medical staff. In addition, HMO is capable of either creating a new physician group, which is called a captive one, or contracting with already existing independent group of various specialists. A group model allows HMOs to fill the basic positions and provide their members with a complex of health services. Another closed-panel model is called a staff model and considered to be the most restrictive plan of providing medical services. This model is considered to be the most spread in the health care market (Ozcan, 2008). The physicians are the official employees hired by HMO on the most common positions to match the needs of the HMO members (Kongstvedt, 2013). However, doctors are affixed to a certain medical location and may treat the HMO members only. The given model is characterized by a lower productivity level since the circle of patients is limited, while the physicians lose their right for an independent research work.

Both open-panel and closed-panel classifications of HMOs have strong and weak points. The open-panel models of HMOs are mainly appreciated for the variety of qualified specialists located throughout the service area, which makes it easier for the HMOs members to find a health care provider not far from their houses (Kongstvedt, 2013). Furthermore, the independence of the physicians makes it unnecessary for the HMOs to pay much attention to maintaining a fruitful collaboration between them. However, the employment of the private practitioners requires bigger funds and reduces the benefit of HMOs. On the other hand, the closed-panel models of HMOs are more useful for the employers since they do not have to hire administrative staff with the option of leaving routine work for physician groups (Kongstvedt, 2013). Unfortunately, the closed-panel models tend to cause some inconveniences to the HMOs members such as having different doctors or sticking to the location of a medical institution.

Taking into account all mentioned advantages and disadvantages of the various HMOs types, I could claim that the open-panel models are more convenient and universal, thus, more suitable to the conditions of Florida. Furthermore, the 2014 Florida HMOs report has shown that most of the closed-panel HMOs had losses (15 of 34 Florida HMOs Report 2014 Losses, 2014). This fact may be connected with the disproportion between a growing number of enrollees and a lowered quantity of the newly employed medical staff. However, I see no point in shifting the priority to the open-panel models since they are functionally and economically inefficient in medium and large cities that prevail in the state of Florida.

All in all, a deeper insight into the classifications of HPOs has revealed key qualities of the various health care models. The observed advantages and disadvantages have helped to decide which model is the most efficient for Florida.


15 of 34 Florida HMOs Report 2014 Losses. (2015). Web.

Hunter, R. (n.d.). HMO Insurance. Web.

Kongstvedt, P. R. (2013). Essentials of Managed Health Care. Burlington, MA: Jones & Barlett Learning.

Marcinko, D. E., & Hetico, H. R. (2011). Revolving Health Care Industrial Complex: The Changing Health 2.0 Economics and Financial Ecosystem. In D. E. Marcinko (Ed.), The Business of Medical Practice: Transformational Health 2.0 Skills for Doctors (pp. 1-27). New York, NY: Springer Publishing Company.

Ozcan, Y. A. (2008). Health Care Benchmarking and Performance Evaluation: An Assessment Using Data Envelopment Analysis. New York, NY: Springer.

Calculate the price
Make an order in advance and get the best price
Pages (550 words)
*Price with a welcome 15% discount applied.
Pro tip: If you want to save more money and pay the lowest price, you need to set a more extended deadline.
We know how difficult it is to be a student these days. That's why our prices are one of the most affordable on the market, and there are no hidden fees.

Instead, we offer bonuses, discounts, and free services to make your experience outstanding.
How it works
Receive a 100% original paper that will pass Turnitin from a top essay writing service
step 1
Upload your instructions
Fill out the order form and provide paper details. You can even attach screenshots or add additional instructions later. If something is not clear or missing, the writer will contact you for clarification.
Pro service tips
How to get the most out of your experience with Online Academic Experts
One writer throughout the entire course
If you like the writer, you can hire them again. Just copy & paste their ID on the order form ("Preferred Writer's ID" field). This way, your vocabulary will be uniform, and the writer will be aware of your needs.
The same paper from different writers
You can order essay or any other work from two different writers to choose the best one or give another version to a friend. This can be done through the add-on "Same paper from another writer."
Copy of sources used by the writer
Our college essay writers work with ScienceDirect and other databases. They can send you articles or materials used in PDF or through screenshots. Just tick the "Copy of sources" field on the order form.
See why 20k+ students have chosen us as their sole writing assistance provider
Check out the latest reviews and opinions submitted by real customers worldwide and make an informed decision.
Thank you. No issues
Customer 453139, April 17th, 2022
Human Resources Management (HRM)
On time and as always a great service! This semester has been very time consuming a tough for my family so this service has not only been a life saver but helped me keep up my grades! If you are in a time crunch or need help, don't hesitate! They are worth it!
Customer 453077, April 4th, 2022
Thank you!!! I received my order in record timing.
Customer 452551, February 9th, 2021
Emergency Management
Overall, I think it's a great service. I have yet to submit the assignment, so I don't know what kind of grade I'll get. But customer service was excellent. Reviews were made and the assignment proofed for satisfaction.
Customer 453015, December 15th, 2021
It was gotten well after time I needed to make needed additions, but it is something that did help me. I could not get the concept of ho to start such a project but now reading this, I was over thinking the project it seems.
Customer 452801, July 19th, 2021
Business Management
Awesome job, Thank you
Customer 453201, June 12th, 2022
IT, Web
Awesome paper in such a short amount of time. Was in a jam with another service who didn't deliver, but Theresa did the job correctly. I will use her again to do my essays for sure!
Customer 452967, November 27th, 2021
Thank you!
Customer 452545, February 6th, 2021
Business Studies
Thank you very much for a good job done and a quick turn around time.
Customer 452615, March 31st, 2021
Health Care
The writer did not follow my choice of topic (Food/Water Insecurity, Hunger, & Poverty), the paper was instead written about Climate Change in Africa. However, the paper was still great and informative. Thank you!
Customer 452777, January 28th, 2022
Health Care
awesome work
Customer 452777, October 14th, 2021
Professions and Applied Sciences
Thanks. This helps a lot. Was a bit late but some cushion was given.
Customer 453015, February 10th, 2022
Customer reviews in total
Current satisfaction rate
3 pages
Average paper length
Customers referred by a friend
15% OFF your first order
Use a coupon FIRST15 and enjoy expert help with any task at the most affordable price.
Claim my 15% OFF Order in Chat
Live ChatWhatsApp