Which statement describes a Closed Panel HMO?

Which statement describes a Closed Panel HMO?

• A. The most restrictive of the managed health care plans; physicians are employees of the HMO and see only plan members.
• B. The HMO contracts with an Independent Practice Association (IPA) to provide treatment.
• C. Physicians are employees of the HMO and see only plan members.
• D. Care is provided by hospital-employed staff only.

Answer: (C)

A closed-panel HMO restricts access to care by limiting it to providers who are on the HMO’s own panel, with those providers typically employed by the HMO or under exclusive contract and seeing only plan members. This arrangement gives the HMO tight control over costs and utilization because physician services are integrated within the plan and outside-network care is discouraged or not covered. The statement that best describes this is that physicians are employees of the HMO and see only plan members, which captures both the employment/control aspect and the exclusive patient base. The other options describe different provider arrangements—for example, contracting with an Independent Practice Association describes a more open network with private-practice physicians, and care provided by hospital-employed staff only reflects a hospital-centered model rather than a physician-panel arrangement.

A closed-panel HMO restricts access to care by limiting it to providers who are on the HMO’s own panel, with those providers typically employed by the HMO or under exclusive contract and seeing only plan members. This arrangement gives the HMO tight control over costs and utilization because physician services are integrated within the plan and outside-network care is discouraged or not covered. The statement that best describes this is that physicians are employees of the HMO and see only plan members, which captures both the employment/control aspect and the exclusive patient base. The other options describe different provider arrangements—for example, contracting with an Independent Practice Association describes a more open network with private-practice physicians, and care provided by hospital-employed staff only reflects a hospital-centered model rather than a physician-panel arrangement.