In an HMO, the primary care physician acts as the "gate keeper" to all higher levels of care that the patient may need in theory, this means that the physician decides what is best for the patient and coordinates his or her healthcare, while at the same time working to control costs and trying to ensure the delivery of care in the most efficient manner possible.
Thinking about this from both a provider's and payer's perspectives:
- What are the advantages and disadvantages of using the gate keeper system in terms of progressing through the levels of care? Provide an example of each perspective.
- What are at least 2 advantages and disadvantages for each group? Provide a rationale for your choices.