HMO or PPO
The rising costs of medical care in the 1920’s were the start of Americans needing health care insurance. The first type of Health Management Organization (HMO) insurance was a prepaid insurance for the lumber mill workers in Tacoma Washington (Difference and Comparison, n.d.). It consisted of the lumber mill and the employees paying each month for insurance in the event they may need health care in the future. This was successful that in 1929 Ross-Loos Medical group provided and prepaid medical care to the Las Angles water and power and Las Angles county employee’s medical care for a monthly premium. By 1951 they had over 35,000 workers enrolled for their prepaid health care program. Then in 1982 Ross-Loos merged with Insurance Company of North America and Connecticut General to form CIGNA health care.
Blue Cross also saw the benefits of the prepaid medical care that it started their own in 1929. Blue Cross started by offering teachers a 21 day stay at Baylor University health care facilities. This was successful that they then expanded the offer to other Dallas employee groups. Then in 1982 Blue Cross merged with Blue Shield. This was beneficial because Blue Shield focused on physician care and Blue Cross focused on hospital care. The merging of Blue Cross Blue Shield made for an exceptional medical care plan for many individuals because they can get both hospital and physician services under one plan.
In 1995 the 1973 Health Maintenance Act was abolished leaving and opportunity for the health insurance companies to expand their services (Minnesota Historical Society, n.d.). Corporations of 25 or more employees can offer a PPO plan without offering the HMO. This plays a significant role on the insurance companies to market their plans as more beneficial over other insurance companies.
There are significant differences between both plans and the consumer can decide which one is best for them. For this to happen the
References: Difference and Comparison. (n.d.). HMO vsPPO. Retrieved from http://www.diffen.com/difference/HMO_vs_PPO Kronick, R. (n.d.). Comparison of Cigna Choice Fund and the Blue Cross PPO. Retrieved from http://kronick.ucsd.edu/comparison Minnesota Historical Society. (n.d.). Health Maintenance Organizations. Retrieved from http://www.mnhs.org/library