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Related Experiment Videos

Is success spelled g-a-t-e-k-e-e-p-e-r?

E Zalta1

  • 1CAPP CARE, Newport Beach, CA 92660.

Medical Interface
|March 9, 1994
PubMed
Summary
This summary is machine-generated.

Point-of-service (POS) plans may increase healthcare costs. This study investigated if using gatekeepers in POS plans can lower health plan expenses, addressing concerns about healthcare reform mandates.

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Area of Science:

  • Health Services Research
  • Healthcare Management
  • Health Economics

Background:

  • The President's health care reform proposal mandates Point-of-Service (POS) plans for accountable health plans.
  • Existing evidence does not conclusively demonstrate that POS plans control healthcare costs.
  • There is concern that POS plans may exacerbate healthcare cost escalation.

Purpose of the Study:

  • To evaluate the association between the utilization of gatekeepers within POS plans and overall health plan costs.
  • To determine if a specific managed care strategy can mitigate potential cost increases from POS mandates.

Main Methods:

  • A study was conducted by a managed care organization.
  • The research focused on analyzing cost data within POS plans.

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  • The primary variable examined was the implementation and use of gatekeepers.

    • Main Results:

    • The study aimed to identify if gatekeeper utilization correlates with reduced health plan expenditures.
    • Analysis focused on comparing costs in POS plans with and without gatekeeper systems.
    • Results were intended to provide empirical data on the cost-effectiveness of gatekeepers in POS plans.

    Conclusions:

    • Findings will inform the effectiveness of gatekeepers in managing costs within mandated POS plans.
    • The study's conclusions will guide managed care organizations in adapting to health care reform.
    • Evidence on gatekeeper impact can influence future healthcare policy and plan design.