Some physicians see both types of patients. However, due to the increasing cost of private medical insurance, many companies now favor a managed care system for their employees. As a result, more employers are only offering their employees managed care plans for their health care needs. Therefore, the number of managed care networks is growing, and more physicians are looking to participate in these networks in order to maintain an active practice. Doctors can be left out of managed care networks for a number of reasons.
Many networks start out actively recruiting physicians to participate in their plans.
Later, when the networks have enough medical and surgical specialists in their plans, these networks can become difficult for other physicians to join. For example, physicians are usually more in demand than are doctors who are specialists. Therefore, a doctor's specialty may affect his or her chances of being accepted into the network. It may simply depend on whether the group believes it has enough physicians of various specialties to meet the needs of the patients who are enrolled in the network. Some networks may evaluate doctors by looking at how many and what kinds of tests they order for their patients, whether tests or procedures are performed on an inpatient or outpatient basis, and if a patient is hospitalized, how much time he or she spends in the hospital.