Unit 4 continued | Human Resource Management homework help

 

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The gatekeeper system has many advantages and disadvantages, The gatekeeper is often times the ‘shot-caller’ as far as the continuum of care, making referrals to specialists and such which can be at a disadvantage for both the other providers and the patients. The right of patients are to choose their providers and have accessibility to whichever form of care they want as they are the insured person. The other disadvantage is that it limits specialists to maximize claims processed or the number of patients they see as PCP’s only refer if they see fit. The gatekeeper system can also limit the scope of care for a patient as the PCP, who is not specialized to every form of treatment, will refer based on his/her discretion.

 

An article that I read dated in 1998, ‘Is the Gatekeeper Necessary?’ by Michael Bradford, the article  discussed the disintegration  of the gatekeeper system. It has been 19 years since that article and the gatekeeper system still exists and I believe even more widely utilized in order to control healthcare costs as the costs rose into the billions.One advantage of the gate keeper system is that; the control of costs billed to insurances. Alot of patients also tend to abuse the system for prescription medications and pain management just for the prescription.

 

 

Bradford, M. (1998, August 2). IS THE GATEKEEPER NECESSARY? | Business Insurance. Retrieved January 21, 2017, from http://www.businessinsurance.com/article/19980802/ISSUE01/10005546/is-the-gatekeeper-necessary

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