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How to Select a Sound HMO

Posted in Health Care, HMO by Erineus on May 12, 2009

May 11, 2009, 4:13pm

The average life-span of a company-HMO relationship is three years. This was confirmed by Norman Amora, IntelliCare’s Assistant Vice President for Sales and Marketing. The termination of the HMO-client relationship is often triggered by successive failures of the HMO to deliver promised services.

But with IntelliCare’s outstanding performance and excellent client relationship, the average life-span is almost always surpassed.

The habit of changing HMO every three years or so can put tremendous stress on companies and most especially the employees, who will have the burden of orienting themselves again on how to avail the benefits of their health plans.

According to Amora, the cost of an HMO’s package remains the top consideration for companies. However, by focusing solely on the cost, some companies tend to overlook the corresponding benefits included in the HMO package.

Aside from the high cost of an HMO, another common problem that leads to the short life-span of HMO-client relationship is the problem on contract implementation and interpretation.

Among the most common reported problems are vagueness of the coverage and limits of the health plan, unclear procedure on how to use the health card and bad service (i.e. absence of quality doctors in the HMO accredited facilities).

With a client retention rate of over 90%, IntelliCare shares the reasons for its strong client retention.
These are pricing/premiums, benefit package, network, financial capability and service.

This is usually the primary consideration of most companies. Fair pricing are the key words.

As long as the package is priced justifiably with corresponding guarantee that the services enumerated in the package will be delivered efficiently, then all stakeholders will be satisfied and the client will likely be retained.

Any HMO benefit package must include the basics, such as access to clinics and tertiary hospitals. The benefit package must also be tailor fit to the company’s needs.

“To be able to tailor fit the health care package, the HR has to be involved with the health consultant of the provider,” Amora says.

Caution must be set when appraising the HMO benefit package. The package should be fair and must be in the most feasible of terms. Most importantly, it must be within the budget of the company.
An HMO’s strength is measured in terms of its network. This includes the hospitals, clinics, and other facilities as well as expert resources (i.e. doctors and specialists).

http://www.mb.com.ph/node/200211

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