Blue Cross/Blue Shield-sponsored prepaid individual practice

Area of Science:

• Healthcare Management
• Health Insurance Systems
• Managed Care Organizations

Background:

• The Blue Cross/Blue Shield System has developed numerous Health Maintenance Organization (HMO) programs.
• Currently, 45 Blue Cross/Blue Shield Plans operate 54 HMO programs nationwide.
• These programs collectively serve approximately 1,040,000 members.

Purpose of the Study:

• To analyze the structure and operation of Health Maintenance Organizations (HMOs) within the Blue Cross/Blue Shield System.
• To provide an in-depth examination of a specific HMO affiliate corporation, HMO Minnesota.

Main Methods:

• Analysis of existing Health Maintenance Organization (HMO) structures within the Blue Cross/Blue Shield System.
• Focus on the Minnesota affiliate corporation, HMO Minnesota, for detailed review.

Main Results:

• The Blue Cross/Blue Shield System actively sponsors a significant number of Health Maintenance Organization (HMO) programs.
• Various organizational models exist, including staff models, group models, and Individual Practice Associations (IPAs).

Conclusions:

• Health Maintenance Organizations (HMOs) are a well-established component of the Blue Cross/Blue Shield System.
• HMO Minnesota serves as a case study for understanding the operational dynamics of these managed care entities.