Health Maintenance Organization / HMO

Some say HMOs put too much emphasis on profits

A medical insurance group that provides health services for a fixed annual fee.

HMOs differ from ordinary health insurance and physician services by offering a range of services such as preventative care for a pre-set payment.

More than 170 million Americans receive their health care through an HMO or some other managed care organisation.

In the past Americans used to have fee-for service health insurance where patients choose their medical service provider and the insurance company paid a percentage of the fees.

In managed care, patients pay lower fees to see their primary physician, but they cannot see a specialist or any other type of service without the primary physicians' approval.

Some fear this had led to greater pressure from insurance companies on doctors not to refer patients onwards.

Following a rising tide of scare stories of people being deprived of treatment, many feel these managed care groups, originally formed to cut costs through consolidation, put profits before the needs of patients.