The researchers also conducted a parallel analysis of a separate, network-model HMO
with the same study criteria as above, where 11,034 patients had a coverage gap and 3,950 had coverage of their gap with generic medications only.
PCA Health Plans is a network-model HMO
with a membership of approximately 113,000 commercial members and 25,000 Medicaid members.
Yet of the 62 predominately network-model HMOs
the group surveyed, 60% require doctors to send all or some laboratory specimens to independent labs, and only 5% allow the doctor to choose which independents they use.
Most IPA- and network-model HMOs shift the liability related to medical care to providers of health care.
IPA- and network-model HMOs have fewer opportunities for risk case-finding.
Each of these elements applies to IPA- and network-model HMOs