Typically, a patient's choice of physicians is limited by the managed care plan's gatekeepers who try to refer patients only to health care facilities and physicians who are members of the plan's network. Often, these gatekeepeers are offered financial incentives to limit a patient's access to expensive medical services. For example, some gatekeepeers receive a bonus at the end of the year from their managed care plans if they keep the number of patients who are hospitalized or who are sent to specialists below a certain number that has been set as a limit for that year. So, a gatekeeper might not be willing to allow you to see a specialist when you want to. Today, physicians can choose to join a managed care network or remain in a medical practice where they see patients who have private insurance coverage or privately pay for a physician's services.
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.