Business Services Industry

Is the gatekeeper necessary?

Business Insurance, August, 1998 by Bradford, Michael

MICHAEL BRADFORD The classic gatekeepers for health maintenance organizations slowly are being removed from their posts. Patient and provider dissatisfaction with the gatekeeper HMO model - where patients must go through primary care physicians for referrals to specialists - along with a lack of proof that gatekeeping holds down costs, is opening up patient access to specialized care.

The gatekeeper model is 'rapidly disappearing,' and there's not much support to keep it, said Barry Rosenfeld, a consultant with Apex Management Group Inc. in Princeton, N.J. 'There's no pressure to keep the gatekeeper,' he said. 'I haven't seen anyone out campaigning for it.' Mr. Rosenfeld and others question whether any savings that come from the gatekeeper system are worth the...

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