What are the 4 models of care within HMOs?

Prepare for the Business of Healthcare and Health Policy Test. Study with multiple choice questions and explanations to ace your exam!

Four main delivery frameworks describe how physician care is organized and paid within HMOs: staff model, group model, independent practice association (IPA) model, and network model. In the staff model, the HMO directly employs physicians and runs its own clinics, paying doctors as employees. In the group model, the HMO contracts with an independent multi‑physician group that hires or coordinates the physicians, with care delivered through that group’s practice. In the IPA model, physicians remain independent in private practice but contract with the HMO through an IPA, which negotiates terms and manages reimbursement while doctors continue private practice. In the network model, the HMO contracts with several physician groups to create a network, allowing patients to see any physician within that network.

The option listing Group, Independent Practice Association, Network, and Staff reflects these four standard models. Terms like Open Panel or Private Practice describe variations within these models but are not typically counted as the four primary models themselves.