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The National Insurance Scheme defines Health Maintenance Organization (HMO) as a private or public incorporated company registered by the scheme solely to manage the provision of health care services through health care facilities accredited by the scheme. There has been accusations of mismanagement of funds by the HMOs including ill and nonchalant treatment of their clients. How can we make HMOs more accountable for their clients regarding access to care, the package of care and satisfaction with their services? A lack of accountability can even put patients’ lives at risk. Therefore, a culture of accountability in healthcare can help prevent such thing from happening. And this accountability in healthcare includes clear policies and procedures which will go a very long way to help. How do they create this culture accountability in healthcare? They can achieve this by aligning their vision, strategy and tactics. Therefore, it’s important for the healthcare organization to establish and regularly communicate their core values. Formalizing the values and mission can help to make sure the organization is moving in a positive direction.Health Management Organizations and Accountability in Nigeria