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.
Since 2003, Blue Shield has been the only statewide network-model HMO
PCA Health Plans is a network-model HMO
with a membership of approximately 113,000 commercial members and 25,000 Medicaid members.
DirectCare is a network-model HMO
, which became operational in January of 1998 after five years of successfully managing costs through an Independent Practice Association (IPA) environment.
This unprecedented transition is the result of an April 2002 decision by CalPERS to consolidate HMO offerings, leaving Blue Shield as the only statewide network-model HMO
for CalPERS members.
The agreement with Lifeguard closely follows Blue Shield's recent selection as the principal network-model HMO
offered to members of the California Public Employees Retirement System (CalPERS).
The conference was sponsored by Stanford University in collaboration with ASHP, which offers complementary medicine through health maintenance organizations (HMOs), and by Health Net, a network-model HMO
based in Woodland Hills, Calif.
This growth is expected as a result of CalPERS' recent decision to consolidate its network-model HMO
business with Blue Shield and a few small regional plans.
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