Which of the following best describes the Gatekeeper Concept?

Study for the Ohio Health Insurance Exam. Study with flashcards and multiple choice questions, each question has hints and explanations. Get ready for your exam!

The Gatekeeper Concept is primarily focused on managing patient access to healthcare services in a cost-effective manner. In this model, a primary care physician acts as the gatekeeper who coordinates patient care. This means that patients must first visit their primary care provider before being referred to specialists. This approach ensures that members receive specialized care only when it is deemed necessary based on their primary care evaluation.

By directing members to specialists only when necessary, the Gatekeeper Concept helps to reduce unnecessary healthcare costs and ensures that specialists are utilized appropriately. This can lead to improved health outcomes by ensuring that patients receive the appropriate level of care based on their individual health needs.

The other choices do not accurately reflect the principles of the Gatekeeper Concept. Ensuring complete freedom of choice, allowing unrestricted access to providers, and providing one-on-one counseling do not align with the intent of managing healthcare resources effectively through a primary care coordination system.

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy