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An open panel HMO allows doctors to participate in the program through an independent practice association, giving them the freedom to see patients not connected to the HMO. This structure was not part of the original design of HMOs, which assigned patients to specific physicians. Open panel HMOs began appearing in the 1980s and 1990s, offering benefits to both patients and doctors. Doctors could contract with an intermediary group practice HMO association to see HMO patients and still refuse any patient associated with the HMO.
An HMO Open Panel is a health maintenance organization that allows individual physicians to participate in the program through the auspices of an independent practice association. A doctor who participates in an HMO is thus free to see patients who are not connected to the organization and does not commit to taking on a patient simply because they are with the HMO. This is in contrast to a closed panel HMO, where the physician is directly related to the HMO and is under contract to all HMO members assigned to the physician by the organization.
An open panel HMO was not part of the original design for a health maintenance approach to health coverage. The concept of a health maintenance organization dates back to the early 1970s in the United States. Initially, HMOs functioned as a means of delivering healthcare over the network. That is, people covered by the HMO’s terms were assigned to specific physicians and were free to use any medical facility that contracted with the HMO’s provider. Over the next few years, coverage was expanded to allow members to see any doctor who contracted directly with the HMO.
Open panel HMO structures began appearing in the 1980s and 1990s. There were several benefits to this arrangement for both patients and doctors. The patient was able to pay a fixed fee in exchange for quality medical care and has the choice of a wide range of doctors as a primary care provider. This was in contrast to the previous provision that, to cover medical costs, the patient should only use doctors and medical facilities contracted with HMOs.
For the doctor, the open-panel HMO meant that it was no longer necessary to contract directly with the HMO to see patients with this type of cover. He or she could simply contract with an intermediary group practice HMO association that had contracted with the HMO and be able to see HMO patients and be paid for services rendered. At the same time, the doctor is still able to refuse any patient associated with the HMO if he feels that action is justified, without incurring any censure. Physicians who wish to continue treating a patient outside the confines of a health maintenance organization often prefer to opt for an open panel HMO arrangement.
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