What type of managed care organization requires patients to select in-network providers for coverage?

The Health Maintenance Organization (HMO) model requires patients to choose in-network providers for coverage. This structure is designed to manage costs effectively by promoting the use of a defined network of healthcare providers and facilities. Within an HMO, primary care physicians often act as gatekeepers, guiding patients to specialists and other services within the network. By selecting in-network providers, members benefit from lower out-of-pocket costs and comprehensive care coordination.

While other types of managed care organizations like Preferred Provider Organizations (PPOs) and Exclusive Provider Organizations (EPOs) operate with networks, they offer more flexibility. In PPOs, for example, patients can see out-of-network providers, albeit at a higher cost, whereas EPOs allow for some flexibility but still require services to be obtained exclusively from in-network providers without out-of-network benefits. Thus, the distinctive characteristic of an HMO is its strict requirement for in-network provider selection as a condition of receiving coverage.