Biomaterial Database

Subscriber suits: how to avoid them. 1986

S M Lloyd, and B S Elkins

As HMOs and PROs become more significant elements of the health delivery system, they also become more likely targets for lawsuits. This article identifies twelve major liability risks of these organizations as well as those who provide services to HMOs and PPOs. Also presented are steps that can be taken to help protect against those risks.

UI	MeSH Term	Description	Entries
D007348	Insurance, Health	Insurance providing coverage of medical, surgical, or hospital care in general or for which there is no specific heading.	Group Health Insurance,Health Insurance,Health Insurance, Voluntary,Health Insurance, Group,Health Insurances,Insurance, Group Health,Insurance, Voluntary Health,Insurances, Health,Voluntary Health Insurance
D007351	Insurance, Liability	Insurance against loss resulting from liability for injury or damage to the persons or property of others.	No-Fault Insurance,Insurance, No-Fault,Liability Insurance,No Fault Insurance
D008318	Malpractice	Failure of a professional person, a physician or lawyer, to render proper services through reprehensible ignorance or negligence or through criminal intent, especially when injury or loss follows. (Random House Unabridged Dictionary, 2d ed)	Professional Negligence,Negligence,Negligence, Professional,Professional Negligences
D011243	Preferred Provider Organizations	Arrangements negotiated between a third-party payer (often a self-insured company or union trust fund) and a group of health-care providers (hospitals and physicians) who furnish services at lower than usual fees, and, in return, receive prompt payment and an expectation of an increased volume of patients.	Organizations, Preferred Provider,Preferred Provider Organization,Organization, Preferred Provider
D005376	Financial Management	The obtaining and management of funds for institutional needs and responsibility for fiscal affairs.	Endowments,Financial Activities,Funds,Activities, Financial,Activity, Financial,Endowment,Financial Activity,Fund,Management, Financial
D006279	Health Maintenance Organizations	Organized systems for providing comprehensive prepaid health care that have five basic attributes: (1) provide care in a defined geographic area; (2) provide or ensure delivery of an agreed-upon set of basic and supplemental health maintenance and treatment services; (3) provide care to a voluntarily enrolled group of persons; (4) require their enrollees to use the services of designated providers; and (5) receive reimbursement through a predetermined, fixed, periodic prepayment made by the enrollee without regard to the degree of services provided. (From Facts on File Dictionary of Health Care Management, 1988)	Group Health Organizations, Prepaid,HMO,Prepaid Group Health Organizations,Health Maintenance Organization,Organizations, Health Maintenance,Organization, Health Maintenance
D012308	Risk Management	The process of minimizing risk to an organization by developing systems to identify and analyze potential hazards to prevent accidents, injuries, and other adverse occurrences, and by attempting to handle events and incidents which do occur in such a manner that their effect and cost are minimized. Effective risk management has its greatest benefits in application to insurance in order to avert or minimize financial liability. (From Slee & Slee: Health care terms, 2d ed)	Hospital Incident Reporting,Incident Reporting, Hospital,Hospital Incident Reportings,Incident Reporting,Incident Reportings, Hospital,Management, Risks,Reporting, Hospital Incident,Reportings, Hospital Risk,Voluntary Patient Safety Event Reporting,Hospital Risk Reporting,Hospital Risk Reportings,Incident Reportings,Management, Risk,Reporting, Hospital Risk,Reporting, Incident,Reportings, Hospital Incident,Reportings, Incident,Risk Reporting, Hospital,Risk Reportings, Hospital,Risks Management
D014481	United States	A country in NORTH AMERICA between CANADA and MEXICO.