Health Maintenance Organization (HMO)

Staff model (practitioners are salaried employees of the HMO)

Group model (HMO pays a group of practitioners a negotiated, per capita rate, which is then distributed among the individuals)

Network model (practitioners work out of their own offices under contract with the HMO)

Individual Practice Association (IPA) model (practitioners continue individual or group practice with compensation by capitation and/or fee-for-service [FFS] plans)

Mixed model (combination of two or more of the above)

An organized system of health care that provides a comprehensive range of health care services to a voluntarily enrolled population in a geographic area on a primarily prepaid and fixed periodic basis

National Committee for Quality Assurance (NCQA)

Accreditation Association for Ambulatory Health Care (AAAHC)

Utilization Review Accreditation Commission (URAC)

Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

Federal licensing agencies, state insurance commissions, state departments of mental health, and state departments of public health

Preferred Provider Organization (PPO)

A network discount, FFS provider arrangement with incentives to stay inside the network; allows services outside of the PPO network at an increased copayment and/or deductible; has structured quality and utilization management

NCQA

JCAHO

URAC (after its purchase of the American Accreditation Program, Inc.)

State insurance departments