PPO vs HMO

I was asked the other day what PPO & HMO mean...here's what the acronyms stand for...

PPO: Preferred Provider Organization

HMO: Health Maintenance Organization

What does this mean to you? Often times if you're on an HMO plan you need to "declare" a PCP with your insurance carrier and must have referrals to see a specialist.  If you have a PPO plan you likely don't need to have referrals to see specialists.  In either case you want to be certain that the doctor's you see are in network with your PPO or HMO plan. 

Another question was why doesn't our health care system work more like building contractors?  In other words why can't the hospital take one payment from the insurance carrier and patient and then divide it accordingly to the hospital, surgeon, and anesthesiologist when a patient has surgery?  I was intrigued by this question and plan to do some research into it.  I have a sneaky suspicion that there are some federal and state regulations out there that would keep something like this from working, but with a major overhaul to our health care system it could have potential. 

What are your thoughts?

deargabbyinsurance@yahoo.com