response to discussion

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There are different types of managed care organizations and the common ones are PPO's and HMO's. PPO's are Preferred Provider Organizations and HMO's are Health Maintenance Organizations, the most common HMO in my area is Kaiser. HMO's work differently because the primary care provider works as a gatekeeper to determine if a specialist is necessary for the patient, for treatment or diagnosis. My mom has Kaiser and there are plenty of other hospitals in the area that provide care or have Kaiser doctors available but there is a lack of communication between the two where they don't always have access to her information and that can be frustrating for patients and staff. Does having an HMO such as Kaiser work towards reducing the cost of healthcare? Possibly, there's no real way to compare the insurances with those who are insured because every person has a different level of health and the history is not the same either so you wouldn't exactly be able to those patients are healthier but you can see that those people have access to their primary care doctor who will or will not determine if more testing or access to care is necessary. The HMO plan does serve a purpose in reducing cost by limiting unnecessary appointments with specialists and for those who go for yearly physicals and need visits with specialists that just means that the patient's out of pocket cost is less than if they didn't have an HMO. Shin, J., & Moon, S. (2007). Do HMO Plans Reduce Health Care Expenditure in the Private Sector?. Economic Inquiry, 45(1), 82-99.