Relationships between HMOs and health care providers

This article describes the forces that have brought HMOs into prominence as alternative health care delivery systems, and describes staff, group, and open panel HMOs. The authors discuss the key issues physicians should consider before contracting with an HMO--risk-sharing, payment, and exclusivity--as well as issues in hospital contracts with HMOs that affect physicians--such as payment, verification of coverage, utilization review, and medical staff membership. Finally, the authors discuss hospital-physician joint ventures to operate local HMOs or negotiate with existing HMOs.