HEALTH MAINTENANCE ORGANIZATION

HEALTH MAINTENANCE ORGANIZATION (HMO). The HMO established between MEDICAL ASSOCIATES CLINIC PC (THE) and the JOHN DEERE DUBUQUE WORKS in July, 1982 was area's first health maintenance organization. (1) The decision to establish a Medicare plan for seniors was made in 1983. The program expanded into Wisconsin in 1984 and Illinois in 1985. In 2017 Medical Associates Health Plans serviced approximately a 45-mile radius of Dubuque although there were offices in Monona, Wisconsin and Elkader, Iowa. Family practices existed in all three states. (2)

HMOs presented employers with an alternative to health insurance. Participating companies contracted with the clinic and other participating doctors for health care of employees. Costs were contained because doctors were forced to work within pre-determined health care payments. Employees were also encouraged to see their doctor to address concerns before the health of the person declined further. (3)

In 2018 employers could choose from multiple health plans. The tri-state plan included all Medical Associates Clinic providers and locations and most family medicine providers in the area and all hospitals within a 60-mile radius of Dubuque. Other plans included areas of eastern, northern, and southeast Iowa. (4)

Zach Keeling, the organization's chief operating officer, found that the Medical Associates Health Plans were one of just two owned by physicians' groups. The plans were one of just one hundred plans owned by a health system. In 2017 Medical Associates Plans were one of only 17 in the nation to receive a five-star ratings (top possible scores) from the Centers of Medicare and Medicaid Services and the National Committee for Quality Assurance Health Ratings. This rating had been awarded annually since the rating system had started in 2011. Prior to that, the health plans had received an Excellent (then the highest rating). (5) Of 42,000 people served, 15,000 were receiving supplemental care for Medicare, a federally funded program providing coverage primarily for those 65 and older, and younger people with disabilities. (6)

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Source:

1. Jacobson, Ben, "Top Marks," Telegraph Herald, December 9, 2018, p. 1D

2. Salwolke, Scott, "35 Years of Healthy Efforts," Telegraph Herald, March 9, 2017, p. 42

3. Hammil, Roxie. "Dubuque-Area Hospitals, Clinics from Some Victories..." Dubuque, On the Road Again, Telegraph Herald, June 26, 1983

4. Jacobson

5. Advertisement, Telegraph Herald, December 18, 2002, p. 31

6. Jacobson