Consumer-driven HMO a step in right direction.(services of Health Net of California Inc.)(Brief article)

Business Insurance, June, 2007

Can consumer-driven health plan features be successfully incorporated into a health maintenance organization to form a new hybrid product? We think so and are glad to see that California-based Health Net Inc. has done just that. Enrollees in the Health Net Optimizer HMO, like a traditional HMO, must go to network providers to receive coverage.

Like a consumer-driven health care plan, though, enrollees have financial incentives to use health care services carefully. Among other things, enrollees can tap employer-funded health reimbursement arrangements to pay for out-of-pocket expenses, such as coinsurance for hospitalization. Unused HRA balances can be rolled over to pay for succeeding years expenses. As Health Net's Chief Commercial Officer Mark Morgan...

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