Evidence Required to Prove Criteria for Designation as Community-Based Health Maintenance Organization - Mo. Code Regs. Ann. tit. 20, § 400-7.300

Health maintenance organizations (HMOs) that want to be designated as community based HMOs, must meet certain criteria laid out by regulations.  The HMO must demonstrate its involvement in performance improvement as well as public accountability of cost, quality and access to health care.  Specific requirements include:

1.      Identifying specific health indicators affecting the community that the HMO serves;

2.      Describing how the HMO will improve performance within the community;

3.      Describing methods of financial accountability as well as providing quality care;

4.      Utilizing community participation.