health maintenance organization (redirected from Health maintenance organization (HMO))

health maintenance organization /health main·te·nance or·ga·ni·za·tion/ (HMO) a broad term encompassing a variety of health care delivery systems utilizing group practice and providing alternatives to the fee-for-service private practice of medicine and allied health professions.

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health maintenance organization

n.

An HMO.

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health maintenance organization (HMO),

a type of group health care practice that provides basic and supplemental health maintenance and treatment services to voluntary enrollees who prepay a fixed periodic fee that is set without regard to the amount or kind of services received. In addition to diagnostic and treatment services, including hospitalization and surgery, an HMO often offers supplemental services, such as dental, mental, and eye care, and prescription drugs. Federal financial support for the establishment of HMOs was provided under Title XIII of the 1973 U.S. Public Health Service Act.

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health maintenance organization,

n corporation formed to provide health care, often financed by the employer and employee insurance premium payments. Participating physicians, clinic, and hospital staff provide prevention and treatment to enrolled members and their families.

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health,

n a bodily state in which all parts are functioning properly. Also refers to the normal functioning of a part of the body. A state of normal functional equilibrium; homeostasis.

health, ASA classification,

n a classification system for ranking the level of a patient's physical health, established by the American Society of Anesthesiologists (ASA). Patients are classified as ASA I, indicating a patient in a normal state of health, with no apparent disease. ASA II indicates a patient with a mild disease. ASA III indicates a patient with a serious disease, which may limit normal activity but does not cause incapacitation. ASA IV indicates a patient with a life-threatening and incapacitating disease. ASA V indicates a declining patient who is not expected to live beyond a day, regardless of medical attention. ASA E indicates emergency status when added to any of the normal status designations.

health assessment,

n an evaluation of the health status of an individual by performing a physical examination after obtaining a health history. Various laboratory and functional tests may also be ordered to confirm a clinical impression or to screen for possible disease involvement.

health behavior,

n an action taken by a person to maintain, attain, or regain good health and to prevent illness. Health behavior reflects a person's health beliefs.

health care clearing house,

n an entity used to process or aid in the processing of information; may also be called a repricing company, billing service, community health information system, community health management information system, or “value-added” switch or network.

health care operations,

n.pl the functions performed by a health care provider, health care plan, or health care clearing house to conduct administrative and business management activities.

health care professional,

n a person who by education, training, certification, or licensure is qualified to and is engaged in providing health care.

health care provider,

n an individ-ual who provides health services to health care consumers (patients).

health education,

n an educational program directed to the general public that attempts to improve, maintain, and safeguard the health care of the community.

health hazard,

n a danger to health resulting from exposure to environmental pollutants such as asbestos or ionizing radiation, or to a lifestyle influence such as cigarette smoking or chemical abuse.

health history,

n previously diagnosed physical or mental condition of an individual. Also called
medical history. See also health assessment and chart, history.

health information,

n recorded information in any format (e.g., oral, written, or electronic) regarding the physical or mental condition of an individual, health care provision, or health care payment. See also health assessment and health, patient.

health information, individually identifiable,

n recorded information in any format (e.g., oral, written, or electronic) regarding the physical or mental condition of an individual, health care provision, or health care payment. It contains demographic information able to specifically distinguish an individual. In some cases, this information may not be considered “protected.” See also health information, protected.

health information, protected (PHI),

n recorded information in any format (e.g., oral, written, or electronic) regarding the physical or mental condition of an individual, health care provision, or health care payment. It contains demographic information able to specifically distinguish an individual. See also health information, individually identifiable.

Health Insurance Portability and Accountability Act (HIPAA),

n a public law enacted by Congress in 1996, consisting of two parts. Title I of the act protects workers and their families from the loss of health insurance coverage should they change or lose their jobs. Title II of the act calls for the establishment of national standards for electronic health care records, as well as national identities for health care providers, health insurance plans, and employers. In addition, Title II protects the privacy and security of an individual's health information.

health maintenance organization (HMO),

n a legal entity that accepts responsibility and financial risk for providing specified services to a defined population during a defined period at a fixed price. An organized system of health care delivery that provides comprehensive care to enrollees through designated providers. Enrollees are generally assessed a monthly payment for health care services and may be required to remain in the program for a specified amount of time.

health, patient,

n the state of bodily soundness of the patient; the patient's absolute or relative freedom from physical and mental disease.

health physics,

n the study of the effects of ionizing radiation on the body and the methods for protecting people from the undesirable effects of radiation.

health policy,

n 1. a statement of a decision regarding a goal in health care and a plan for achieving that goal; e.g., to prevent an epidemic, a program for inoculating a population is developed and implemented.
n 2. a field of study and practice in which the priorities and values underlying health resource allocation are determined.

health promotion,

n an educational program or effort directed at a targeted population to improve, maintain, and safeguard the health of that segment of society. See also health education.

health resources,

n all materials, personnel, facilities, funds, and anything else that can be used for providing health care and services.

health risk,

n a disease precursor associated with a higher than average morbidity or mortality. The disease precursors may include demographic variables, certain individual behaviors, familial and individual histories, and certain physiologic changes.

health risk appraisal,

n a process of gathering, analyzing, and comparing an individual's prognostic characteristics of health with a standard age group, thereby predicting the likelihood that a person may develop prematurely a health problem associated with a high morbidity and mortality rate.

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health maintenance organization

See HMO.