Definitions for "Group Model HMO"
This type of closed-panel HMO generally is made up of one or more physician group practices that are not owned by the HMO but operate as independent partnerships or professional corporations. Instead of employing the doctors and paying them salaries, the HMO contracts with the group practice to provide or arrange covered services for each HMO member who is a patient of the group.
Health care plan involving contracts with physicians organized as a partnership, professional corporation, or other legal association. It can also refer to an HMO model in which the HMO contracts with one or more medical groups to provide services to members. In either case, the payer or health plan pays the medical group, which is, in turn, is responsible for compensating physicians. The medical group may also be responsible for paying or contracting with hospitals and other providers.
An HMO that contracts with a multispecialty medical group to provide care for HMO members; members are required to receive medical care from a physician within the group unless a referral is made outside the network.
(see Health Maintenance Organization)