What is HEALTH CARE FINANCING ADMINISTRATION?
The Health Care Financing Administration (HCFA), part of the Department of Health and Human Services, administers Medicare and Medicaid with the assistance of Social Security Administration offices throughout the country. The HCFA establishes the standards medical providers and organizations must meet to be certified as qualified Medicare providers. What is HEALTH MAINTENANCE ORGANIZATIONS (HMOS)? These are health plans that contract with medical groups to provide a full range of health services for their enrollees at a fixed pre-paid, per-member fee. There are three different kinds of HMOs: • Group model HMOs contract with independent groups of physicians that provide coordinated care for large numbers of HMO patients for a fixed, permember fee. These groups will often care for the members of several HMOs. • Staff model HMOs employ salaried physicians and other health professionals who provide care solely for members of one HMO. • Independent Practice Associations (IPA) contract with
