Kentucky Health Insurance Practice Exam

HMOs that are patients' cooperatives are____while those owned by physicians are typically______.

1. For-profit, nonprofit

2. Emergency facilities, routine outpatient facilities

3. Routine outpatient facilities, emergency facilities

4. Nonprofit, for-profit

The correct answer is: Nonprofit, for-profit

HMOs, or Health Maintenance Organizations, can be structured in various ways depending on their ownership and operational objectives. In the context of patients' cooperatives, these organizations are typically formed to serve the community's health needs in a more collaborative manner, focusing on shared benefits among members rather than profit generation. This structure leads to a nonprofit operational model, emphasizing patient care over financial profit. On the other hand, HMOs that are owned by physicians often follow a different pathway. Physician-owned HMOs are typically organized with the intention of generating profit for their owners, who are usually the practicing doctors within the organization. This for-profit model allows physician-owned HMOs to reinvest earnings into their services and infrastructure, potentially improving the quality and access to care for their patients. Choosing the correct answer reflects an understanding of how ownership structures influence the operational goals and nonprofit versus for-profit characteristics of HMOs. The distinction between cooperative models emphasizing community care and physician ownership focusing on profitability is essential in health insurance discussions.