List of HMO Plans

Health maintenance organizations, commonly known as HMOs, negotiate treatment costs with a network of health-care providers and typically require members to visit doctors and facilities within the network. HMOs are available from employers and to individuals; plans vary based upon model type and other factors.

Independent Practice Association

• Individual private-practice doctors may contract with an independent practice association, or IPA, which acts as a middleman between the doctors and the HMO. The IPA contracts with the HMO organization, and the physicians receive a preset amount per patient or a general fee to care for members of the IPA. This is also called an open-panel model, because the doctor keeps his own office and can also see patients who aren't affiliated with the HMO.

Staff Model

• When a doctor works directly for an HMO, they're part of a staff model. This means they're paid directly by the HMO organization and most likely have offices in the HMO's building. This is considered a closed-panel HMO, because the doctors can only see patients who belong to their affiliated HMO program.

Group Model

• As with the IPA model, the physicians in a group model HMO are independent employees. In a group model, the doctors have their own contract with an HMO and earn a negotiated fee for every HMO program member they treat. Unlike the IPA model, the group decides how the money is distributed to the group members; it's also a closed-panel model. However, in a group model, the physicians do have oversight over medical staff and other employees, unlike in the staff model.

Network Model

• The network model, or mixed model, combines more than one type of model into its plan. For example, a network model HMO may offer patients care through their staff model, as well as an option to select a doctor from an IPA. This is common with HMO groups, as it allows for more patient choice.