Healthcare Delivery Models

Question 1

What are the four main types of Healthcare Delivery Models?

Answer 1

• Accountability care organizations (ACO)
• Patent-centered medical home (PCMH)
• Health maintenance organization (HMO)
• Preferred provider organization (PPO)

Question 2

Explain Accountability care organizations (ACO)?

Answer 2

Groups of physicans, hospitals and care providers come together voluntarily to provide quality care to Medicare patients

Question 3

Explain Patient-centered medical home (PCMH)?

Answer 3

Care delivery model-primary care provider (PCP) coordinates treatment to make sure patient receives required care

Question 4

Explain Health maintenance organization (HMO)

Answer 4

Plan contracts with groups of providers and facilities preventative and acute care for patients. HMOs require referrals to specialist and precertification and preauthorization for hospital admissions, and patient procedures and treatment

Question 5

Explain Preferred provider organization (PPO)

Answer 5

Plan has more flexibility than an HMO. Patient is NOT required to have a PCP, can go directly to a specialist without referrals. In-network and out of network providers