assignment 03: hmo and malpractice | HA4070D-Regulatory Environment in Health Care | National American University
The relationship between health maintenance organizations (HMOs) and member physicians is typically a contractual one. An HMO will usually sign agreements with various medical providers in its network, allowing them to provide care to their members. Members are then obligated to receive care from the physicians in that network if they wish to remain enrolled in the HMO plan. The contract will also outline reimbursement rates for services as well as policies related to patient safety and quality of care among other things. As such, this agreement serves as an integral part of the relationship between an HMO and its member physicians.