Which is an example of a closed-panel HMO?

A group model HMO represents a closed-panel health maintenance organization (HMO) because it contracts directly with a specific group of providers to provide healthcare services exclusively to its members. In a closed-panel arrangement, the members have limited options for accessing healthcare, as they are typically required to seek care only from the physicians and facilities that are part of the HMO’s network. This model allows for better control over costs and the quality of care, as the HMO coordinates all healthcare services through its contracted providers.

With closed-panel HMOs, members typically do not have the flexibility to seek services from outside the network unless they have prior authorization. This fosters a structured approach to healthcare delivery, where the focus is on preventive care and cost management. The grouping of services and resources helps to maintain a continuum of care among members, which can enhance overall health outcomes.

Understanding these distinctions is crucial as other models like direct contract, network, or individual practice associations may involve broader access to providers and services, potentially deviating from the characteristics of a closed-panel system.