#025 – HMO PPO EPO WTF IDK NVM takes a look at the health plan terms you see all of the time, but know nothing about. Scott W. Dowling tells you what you need to know and what you don’t. This is the first of two shows discussing so-called networks and how they affect the price of your health insurance.
Kaiser Cares For Employees and Communities
Henry J. Kaiser started the first prominent Health Maintenance Organization (HMO) in the San Francisco Bay Area during World War II. Kaiser, an industrialist and philanthropist with steel, aluminum and other businesses across the United States, built and staffed a field hospital for his shipbuilding employees. He cared for his employees and the communities where they operated by opening fully staffed hospitals that were the original HMOs.
PPOs follow HMOs By 10 Years
Preferred Provider Organizations started to pop up in the early 1980s as Health Maintenance Organizations fell out of favor. The more flexible PPO offered similar savings to HMOs while allowing insured patients to see the doctors of their choice. While the BUCA (BlueCrossBlueShield, United Healthcare, Cigna, Aetna) subsidiaries created so-called networks of providers, MultiPlan was and is the largest independent Managed Care Organization involved in the Preferred Provider Organization model’s development.
HMO Act of 1973
Long before HIPAA and the Affordable Care Act, Richard Nixon made the first move into federally mandated employee benefits with The HMO Act of 1973. This law provided financial assistance for the further development of HMOs across the United States. It required employers to offer an HMO alternative to traditional insurance if an eligible HMO operated in their area.
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Our next episode will be Part 2 of HMO PPO EPO WTF IDK NVM where we’ll discuss what is changing and evolving in the HMO/PPO world and what it means for you, your family and your company’s employees.
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