full-risk HMO

full-risk HMO

(in U.S. managed care) a health maintenance organization in which the hospital receives capitation (money paid) for all facility and hospital-based physician services. The physician group receives capitation and shares the deficit or surplus of the hospital risk pool. The HMO retains premium dollars and assumes risk for out-of-area emergencies, pharmacy benefits, and vision benefits.

full-risk HMO

(ful-risk)
A health care company fully capitated to include a wide range of benefits across preventive, primary, and acute care services.
References in periodicals archive ?
9 million full-risk HMO and Administrative Services Only (ASO) members in nine states: California, Colorado, Connecticut, Idaho, New Jersey, New Mexico, Pennsylvania, Oregon and Washington.
9 million full-risk HMO and ASO members in nine states: California, Colorado, Connecticut, Idaho, New Jersey, New Mexico, Pennsylvania, Oregon and Washington.
9 million full-risk HMO and administrative services only (``ASO'') members in nine states: California, Colorado, Connecticut, Idaho, New Jersey, New Mexico, Pennsylvania, Oregon and Washington.
AmeriHealth Mercy's core products include full-risk HMOs, management contracts, administrative services, pharmacy benefit management, care management services, and behavioral health care services.