The Medicare PFS payment rates formula is the
sum of work RVU, practice expense RVU and malpractice RVU times the conversion
factor. In addition, each of the three RVUs are adjusted to account
for geographic variations in the costs of practicing medicine in different
areas. This formula shows how a payment rate for an individual service is determined.
The 1973 HMO or Health Maintenance Organization is a United States federal act that passed or endorsed during December 1973. It responded to the concerns of the rapid increase of federal health insurance expenditures and concerns about the wellness and care to those people who are 65 years old and above, younger people with disabilities and undergo dialysis or transplant. The 1973 HMO act gives a trial program that encourages and promote the improvement and development of HMOs. It also granted loans to expand the HMO, removed certain limitations for qualified HMO. Lastly, the act reinforced the term HMO and its greater access to the employer-based market.
I would say HMO. The reason is it says SELECTED physicians. An HMO is an in network where you can only go to certain doctors and facilities. In return the doctors receive a little less than what they would originally be paid by other insurances. PPO's you can go to any doctor you want, however the insurance may not cover as much. Hope this helped. I would go with HMO.
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