A Health Maintenance Organization, or HMO, is a way individual residents of Florida can procure the healthcare they need without incurring unaffordable bills.
Many residents of Coral Gables and the greater Miami may not realize that they are indeed receiving healthcare through an HMO, especially when their lives and overall health are going along well.
When a Florida resident gets seriously ill or severely injured, however, they may quickly realize that being part of an HMO is not what they thought.
In theory, an HMO is supposed to give members of the group access to quality healthcare in a lot of areas by giving patients access to a network of key medical providers, including doctors, hospitals and pharmacies. The members of the HMO, the patients, pay a regular amount for membership much like they would pay premium to an insurance company. They also are expected to pay some established copayment toward the services they use.
In practice, though, HMOs have a lot of control over the quality and extent of care that patients in their network receive since they, after all, are the ones footing the lion’s share of the bill. Sometimes, in the interest of cutting costs and keeping profits high, HMOs may take steps to diminish the quality of medical care offered to patients or encourage their providers to do so.
When this happens, a patient may suffer a worsened condition or a serious injury. Sometimes, an HMOs role in an act of medical malpractice can even lead to a patient’s untimely death. Our law office works hard to hold HMOs accountable in these sorts of circumstances.