title: The gatekeeper effect on managing acute medical conditions.
abstract: This study was designed to analyze whether the gatekeeper approach, by itself, is effective in changing physicians' practice patterns. The effect of the gatekeeper could be isolated, because a 95% overlap existed between contracted physicians in the PPO plan and the POS plan used in the study. In treating low-to-moderately resource-intensive conditions, the results of this episode-of-care study showed that the POS system of care (gate-keeper in place) was no more efficient than the PPO system of care (no gatekeeper mechanism) in terms of overall medical costs.
authors.affiliation: Practice Patterns Science, Maryland Heights, MO 63141, USA.
authors.forename: S
authors.initials: S
authors.lastname: Anderson
authors.forename: D
authors.initials: D
authors.lastname: Cave
mesh_terms: D000208:Acute Disease; D000553:Ambulatory Care / Q000191:economics; D002140:California; D017050:Episode of Care; D017048:Health Care Costs; D006296:Health Services / Q000706:statistics & numerical data; D017722:Hospital Charges; D006801:Humans; D010818:Practice Patterns, Physicians'; D011243:Preferred Provider Organizations; D012017:Referral and Consultation