Healthcare Delivery Models

Accountable care organizations (ACO)

Groups of physicians, hospitals, and care providers come together voluntarily to provide quality care to Medicare patients

Patient-centered medical home (PCMH)

Care delivery model - primary care provider (PCP) coordinates treatment to make sure patients receive required care

Health maintenance organization (HMO)

Plans contracts with groups of providers and facilities preventative and acute care for patients. HMO’s require referral to specialists, and pre certification and preauthorization for hospital admissions, outpatient procedures, and treatments

Preferred provider organization (PPO)

Plan has more flexibility than a PPO. Patient is not required to have a PCP, can go directly to a specialists without referrals. In-network and out of care providers