Question

Research 2 HMO Companies in the Industry

Compare and contrast the difference between the two.

Include in your comparison any hot trends or updates you may find for each company.

Answer 1

HMO ( Health Maintenance Organization) refers to an organization that arranges the health insurance and healthcare benefits plans for the individuals and companies in the US and acts as a liaison with the healthcare providers ( paramedical staff and institutes) on prepaid basis.

Here, the two companies which I had taken for discussion is ANTHEM and BLUE CROSS BLUE SHIELD

ANTHEM: Anthem is a healthcare insurance company offering a wide variety of group medical, dental, and vision plans for small businesses and other organizations as well as Medicare and individual and family plans. This company with enhanced personal health care encourages doctors to spend more time with patients and to understand them in a more depth way. One of the key feature is the members can self-refer choose network, but deductibles and coinsurance amounts apply and one key benefits is as part of Blue Cross Blue Shield, it has very extensive network of PCPs to select.

BLUE CROSS BLUE SHIELD ( BCBS): It is a broad company name referring many different subsidiaries that are located in many states across the country. It insure 1 in 3 Americans, and in states with BCBs. It operates independently and locally. It has a program called Blue distinction, is a program for primary care, that provides safe and effective care for those who seeks. To be a part of this program, they ( physicians) must meet high quality standards of care. A level of predictability helps policy holders to plan and manage effectively to their healthcare costs. There is a predictable, stable copayment, no deductible charges available. It has a large section of PCPs available as part of the BCBs network. If the individual had this insurance plan, no referral code is needed to see some specialists.