health maintenance organization (HMO)
An organization that offers, provides, or arranges for coverage
of designated health services needed by plan members under a prepaid
per capita or prepaid aggregate fixed-sum basis. Services are provided
through contracts and other arrangements into which the HMO enters
with healthcare providers. With limited exceptions, persons enrolled
in an HMO must receive healthcare benefits through these contract
providers or no insurance benefit is provided. See also
Group practice
health maintenance organization;
Independent practice association;
Staff model health maintenance organization.
Links for IRMI Online Subscribers
Only:
IWC XV.F;
PLI XVI.P